Surveillance of nosocomial infections in a neurologic intensive care unit.
OBJECTIVE
To assess data on the epidemiology of nosocomial infection (NI) among neurologic intensive care patients.


METHODS
Prospective periodic surveillance study.


METHODS
An 8-bed neurologic intensive care unit (ICU).


METHODS
All those admitted for more than 24 hours during five 3-month periods between January 1999 and March 2003.


METHODS
Standardized surveillance within the German infection surveillance system.


RESULTS
Three hundred thirty-eight patients with a total of 2,867 patient-days and a mean length of stay of 8.5 days were enrolled during the 15-month study period. A total of 71 NIs were identified among 52 patients. Urinary tract infections (UTIs) were the most frequent NI (36.6%), followed by pneumonia (29.6%) and bloodstream infections (BSIs) (15.5%). The overall incidence and incidence density of NIs were 21.0 per 100 patients and 24.8 per 1,000 patient-days, respectively. Incidence densities were 9.8 UTIs per 1,000 urinary catheter-days (CI95, 6.4-14.4), 5.6 BSIs per 1,000 central venous catheter-days (CI9s, 2.8-10.0), and 12.8 cases of pneumonia per 1,000 ventilation-days (Cl95, 8.0-19.7). Device-associated UTI and pneumonia rates were in the upper range of national and international reference data for medical ICUs, despite the intensive infection control and prevention program in operation in the hospital.


CONCLUSIONS
Neurologic intensive care patients have relatively high rates of device-associated nosocomial pneumonia and UTI. For a valid comparison of surveillance data and implementation of targeted prevention strategies, we would strongly recommend provision of national benchmarks for the neurologic ICU setting.
Zolldann
Dirk
D
Department of Infection Control, Aachen University Hospital, Aachen, Germany. dzolldann@gmx.de
Spitzer
Christoph
C
Häfner
Helga
H
Waitschies
Birgit
B
Klein
Wolfgang
W
Sohr
Dorit
D
Block
Frank
F
Lütticken
Rudolf
R
Lemmen
Sebastian W
SW
D003428:Cross Infection / Q000453:epidemiology*; D005858:Germany / Q000453:epidemiology; D006785:Hospitals, University; D006801:Humans; D007362:Intensive Care Units; D009493:Neurosurgery; D011446:Prospective Studies; D018571:Sentinel Surveillance; D013525:Surgical Instruments / Q000382:microbiology