title: Device-associated hospital-acquired infection rates in Turkish intensive care units. Findings of the International Nosocomial Infection Control Consortium (INICC).
abstract: We conducted a prospective study of targeted surveillance of healthcare-associated infections (HAIs) in 13 intensive care units (ICUs) from 12 Turkish hospitals, all members of the International Nosocomial Infection Control Consortium (INICC). The definitions of the US Centers for Disease Control and Prevention National Nosocomial Infections Surveillance System (NNISS) were applied. During the three-year study, 3288 patients for accumulated duration of 37 631 days acquired 1277 device-associated infections (DAI), an overall rate of 38.3% or 33.9 DAIs per 1000 ICU-days. Ventilator-associated pneumonia (VAP) (47.4% of all DAI, 26.5 cases per 1000 ventilator-days) gave the highest risk, followed by central venous catheter (CVC)-related bloodstream infections (30.4% of all DAI, 17.6 cases per 1000 catheter-days) and catheter-associated urinary tract infections (22.1% of all DAI, 8.3 cases per 1000 catheter-days). Overall 89.2% of all Staphylococcus aureus infections were caused by methicillin-resistant strains, 48.2% of the Enterobacteriaceae isolates were resistant to ceftriaxone, 52.0% to ceftazidime, and 33.2% to piperacilin-tazobactam; 51.1% of Pseudomonas aeruginosa isolates were resistant to fluoroquinolones, 50.7% to ceftazidime, 38.7% to imipenem, and 30.0% to piperacilin-tazobactam; 1.9% of Enterococcus sp. isolates were resistant to vancomycin. This is the first multi-centre study showing DAI in Turkish ICUs. DAI rates in the ICUs of Turkey are higher than reports from industrialized countries.
authors.affiliation: Ondokuz Mayis University Medical School, Samsun, Turkey.
authors.forename: H
authors.initials: H
authors.lastname: Leblebicioglu
authors.forename: V D
authors.initials: VD
authors.lastname: Rosenthal
authors.forename: O A
authors.initials: OA
authors.lastname: Arikan
authors.forename: A
authors.initials: A
authors.lastname: Ozgültekin
authors.forename: A N
authors.initials: AN
authors.lastname: Yalcin
authors.forename: I
authors.initials: I
authors.lastname: Koksal
authors.forename: G
authors.initials: G
authors.lastname: Usluer
authors.forename: Y C
authors.initials: YC
authors.lastname: Sardan
authors.forename: S
authors.initials: S
authors.lastname: Ulusoy
mesh_terms: D000328:Adult; D000368:Aged; D001424:Bacterial Infections / Q000453:epidemiology; D002405:Catheterization, Central Venous / Q000009:adverse effects* / Q000706:statistics & numerical data; D003428:Cross Infection / Q000453:epidemiology* / Q000209:etiology; D024881:Drug Resistance, Bacterial; D005260:Female; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D053717:Pneumonia, Ventilator-Associated / Q000453:epidemiology*; D011446:Prospective Studies; D018571:Sentinel Surveillance; D014421:Turkey / Q000453:epidemiology; D014546:Urinary Catheterization / Q000009:adverse effects* / Q000706:statistics & numerical data; D014552:Urinary Tract Infections / Q000453:epidemiology* / Q000209:etiology