title: Evaluation of risk factors affecting hospital-acquired infections in the neurosurgery intensive care unit.
abstract: The aim of the present study was to identify nosocomial infections (NIs), and their associated risk factors, in patients treated in the neurosurgery intensive care unit (NICU) of our hospital. Patients determined to have NIs between January 2008 and December 2012 were included in the study. Each patient's age, gender, microbiological culture results, underlying conditions, type of NIs, device utilization, total parenteral nutrition, reason for hospitalization, Glasgow score, and treatment were recorded and evaluated using statistical analysis. Risk factors for NIs were analyzed with a logistic regression model. During the five-year period, 60 NI episodes were detected in 56 out of 1643 patients. The mean age of the patient population was 33.3 (1-79) years. Of the patients, 22 were female and 34 were male. The overall incidence rate (NIs/100) and incidence density (NIs /1000 days of stay) of NIs were 3.65% and 6.5/1000 patient days, respectively. Regardless of the year of surveillance, the three most commonly detected NIs were bloodstream infection, shunt infection, and ventilator-associated pneumonia. No statistically significant difference was detected between infected and uninfected patients in terms of sex, age, blood transfusions, or mannitol and steroid use (p ≥ 0.05). In the present study, Glasgow scores, the frequency of prior usage of broad-spectrum antibiotics, and NICU stay durations were significantly higher among patients with infections (p < 0.001). Univariate analysis demonstrated that a low Glasgow score, re-operation, and use of mechanical ventilation were risk factors for NIs. We identified low Glasgow coma scores, long hospital stay duration, use of wide spectrum antibiotics, mechanical ventilation, total parenteral nutrition, and re-operation as risk factors for NIs.
authors.affiliation: 1Department of Neurosurgery, Faculty of Medicine, Dicle University, Diyarbakir, Turkey.
authors.forename: Cüneyt
authors.initials: C
authors.lastname: Göçmez
authors.forename: Feyzi
authors.initials: F
authors.lastname: Çelik
authors.forename: Recep
authors.initials: R
authors.lastname: Tekin
authors.forename: Kağan
authors.initials: K
authors.lastname: Kamaşak
authors.forename: Yahya
authors.initials: Y
authors.lastname: Turan
authors.forename: Yılmaz
authors.initials: Y
authors.lastname: Palancı
authors.forename: Fatma
authors.initials: F
authors.lastname: Bozkurt
authors.forename: Mehtap
authors.initials: M
authors.lastname: Bozkurt
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D003428:Cross Infection / Q000453:epidemiology* / Q000209:etiology*; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D009493:Neurosurgery; D012307:Risk Factors; D055815:Young Adult
keywords: Glasgow score; hospital-acquired infections; intensive care unit; neurosurgery; risk factors