title: Surveillance of device-associated infection rates and mortality in 3 Greek intensive care units.
abstract: BACKGROUND
  Several studies suggest that device-associated, health care-associated infections (DA-HAIs) affect the quality of care in intensive care units, increasing patients' morbidity and mortality and the costs of patient care.
  
  
  OBJECTIVE
  To assess the DA-HAIs rates, microbiological profile, antimicrobial resistance, and crude excess mortality in 3 intensive care units in Athens, Greece.
  
  
  METHODS
  A prospective cohort, active DA-HAI surveillance study was conducted in 3 Greek intensive care units from July 2009 to June 2010. The rates of mechanical ventilator-associated pneumonia (VAP), central catheter-associated bloodstream infection (CLABSI), and catheter-associated urinary tract infection (CAUTI) were calculated along with microbiological profile, antimicrobial resistance, and crude excess mortality.
  
  
  RESULTS
  During 6004 days in intensive care, 152 of 294 patients acquired 205 DA-HAIs, an overall rate of 51.7% of patients or 34.1 DA-HAIs per 1000 days (95% CI, 29.3-38.6). The VAP rate was 20 (95% CI, 16.3-23.7) per 1000 ventilator-days, the CLABSI rate was 11.8 (95% CI: 9.2-14.8) per 1000 catheter-days, and the CAUTI rate was 4.2 (95% CI, 2.5-5.9) per 1000 catheter-days. The most frequently isolated pathogen was Acinetobacter baumannii among patients with CLABSI (37.8%) and Candida species among patients with CAUTI (66.7%). Excess mortality was 20.3% for VAP and CLABSI and 32.2% for carbapenem-resistant A baumannii CLABSI.
  
  
  CONCLUSIONS
  High rates of DA-HAIs, device utilization, and antimicrobial resistance emphasize the need for antimicrobial stewardship, the establishment of an active surveillance program of DA-HAIs, and the implementation of evidence-based preventive strategies.
authors: Nursing Department, National and Kapodistrian University of Athens, Greece.
authors: Eleni
authors: E
authors: Apostolopoulou
authors: Vasilios
authors: V
authors: Raftopoulos
authors: Georgios
authors: G
authors: Filntisis
authors: Prokopis
authors: P
authors: Kithreotis
authors: Evagelos
authors: E
authors: Stefanidis
authors: Petros
authors: P
authors: Galanis
authors: Dimitrios
authors: D
authors: Veldekis
mesh_terms: D000368:Aged; D055499:Catheter-Related Infections / Q000453:epidemiology* / Q000382:microbiology; D002405:Catheterization, Central Venous / Q000009:adverse effects; D003428:Cross Infection / Q000453:epidemiology* / Q000209:etiology / Q000382:microbiology; D004352:Drug Resistance, Microbial / Q000187:drug effects*; D004866:Equipment Contamination / Q000706:statistics & numerical data*; D005260:Female; D006115:Greece / Q000453:epidemiology; D017052:Hospital Mortality; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data*; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D053717:Pneumonia, Ventilator-Associated / Q000453:epidemiology* / Q000382:microbiology; D011159:Population Surveillance; D011446:Prospective Studies; D014552:Urinary Tract Infections / Q000453:epidemiology* / Q000209:etiology / Q000382:microbiology; D012122:Ventilators, Mechanical / Q000009:adverse effects / Q000382:microbiology