[Nosocomial infection control in intensive therapy].
BACKGROUND
Nosocomial infections are common among patients treated in ITU settings. The lower airway and genitourinary systems are frequently infected with multiresistant pathogens, and present a serious epidemiological problem. In 2002, at the Lódź Medical University Hospital, strict infection control measures were developed and introduced to minimize the risk of infections in the ITU.


METHODS
Between 2002-2006, the prophylactic use of imipenem, amoxicillin and fluconazole was forbidden and the use of vancomycin and aminoglycosides was limited. Strict microbiological analysis became mandatory in all ITU patients. To achieve this, isolates from the lower airway and genitourinary track from 1330 ITU patients were analyzed using the disc-diffusion method and the E-test method (for MIC values). The VITEK (BioMerieux) automatic analyzing system was used.


RESULTS
The number of nosocomial infections of the lower airway was reduced from 48.8/100 patients in 2002 to 19.0/100 patients in the period 2005-2006. Infections of the genitourinary, system decreased from 27.0/100 patients in 2002 to 4.7/100 patients in 2006. MRSA, Pseudomonas aeruginosa, Enterobacteriacae, and Acinetobacter species were the most commonly isolated pathogens.


CONCLUSIONS
Although it is impossible to eliminate nosocomial infections, particularly in the ITU setting, close co-operation between clinicians and microbiologists, and monitoring of nosocomial infection patients can markedly reduce the frequency.
Bartoszko-Tyczkowska
Anna
A
Pracownia Mikrobiologii, Uniwersytecki Szpital Kliniczny Nr 1 w Łodzi. annatycz@interia.pl
Gaszyński
Wojciech
W
Baranowska
Agnieszka
A
Tyczkowska-Sieroń
Ewa
E
D019072:Antibiotic Prophylaxis; D016638:Critical Illness; D003428:Cross Infection / Q000382:microbiology / Q000517:prevention & control*; D052978:Disk Diffusion Antimicrobial Tests; D024901:Drug Resistance, Multiple, Bacterial; D006801:Humans; D017053:Infection Control; D007362:Intensive Care Units; D008826:Microbial Sensitivity Tests; D015397:Program Evaluation; D012141:Respiratory Tract Infections / Q000382:microbiology / Q000517:prevention & control*; D013997:Time Factors; D014552:Urinary Tract Infections / Q000382:microbiology / Q000517:prevention & control*