title: Nosocomial infections and risk factors in the intensive care unit of a teaching and research hospital: a prospective cohort study.
abstract: BACKGROUND
  To evaluate the incidence, risk factors and etiology of nosocomial infections (NIs) in the intensive care unit (ICU) of our hospital in order to improve our infection control policies.
  
  
  METHODS
  A 1-year prospective cohort study of nosocomial infection (NI) surveillance was conducted in our ICU in 2008.
  
  
  RESULTS
  Out of 1134 patients hospitalized in the ICU for a period of 6257 days, 115 patients acquired a total of 135 NIs distributed as follows: 36.3% bacteremia, 30.4% ventilator-associated pneumonia (VAP), 18.5% catheter-associated urinary tract infection, 7.4% central-line infection, 5.9% cutaneous infection, and 1.3% meningitis. The incidence rate of NI was 21.6 in 1000 patient-days, and the rate of NI was 25.6%. Length of ICU stay, central venous catheterisation, mechanical ventilation and tracheostomy were statistically significant risk factors for NI. Of all NI, 112 (83%) were microbiologically-confirmed and 68.8% of the isolates were Gram-negative, 27.6% were Gram-positive, and 3.6% were fungi. 23 (17%) were clinically-defined infections. The most frequently isolated organism was P. aeruginosa (25%), followed by S. aureus (21.4%), E. coli (18.7%) and A. baumannii (16.9%).
  
  
  CONCLUSIONS
  The bloodstream was the most common site and Gram-negatives were the most commonly reported causes of ICU infections.
authors.affiliation: Department of Infectious Disease and Clinical Microbiology, Dr. Lütfi Kirdar Kartal Teaching and Research Hospital, Istanbul, Turkey. akoznur@yahoo.com
authors.forename: Oznur
authors.initials: O
authors.lastname: Ak
authors.forename: Ayse
authors.initials: A
authors.lastname: Batirel
authors.forename: Serdar
authors.initials: S
authors.lastname: Ozer
authors.forename: Serhan
authors.initials: S
authors.lastname: Çolakoğlu
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D015331:Cohort Studies; D003428:Cross Infection / Q000453:epidemiology* / Q000382:microbiology; D003710:Demography; D005260:Female; D006760:Hospitalization; D006761:Hospitals; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors; D014421:Turkey / Q000453:epidemiology; D055815:Young Adult