Epidemiological surveillance of bacterial nosocomial infections in the surgical intensive care unit.
BACKGROUND
Intensive care units (ICUs) are associated with a greater risk of developing nosocomial infections (NIs) than other departments.


OBJECTIVE
The aim of this study was to determine the rate, the site and causative organisms of NIs in the surgical ICU at University Clinical Center Tuzla.


METHODS
All patients admitted to the surgical ICU were followed prospectively, for the development of NIs (January-December 2010). Determination of NIs was performed using standardized the Centers for Disease Control and Prevention (CDC) criteria.


RESULTS
94 out of 834 patients (11.27%) developed NIs. Respiratory tract infections were seen in 56 (60%), urinary tract infections in 15 (16%) and gastrointestinal tract infections in 8 (9%) patients. Other infections identified were surgical site, bloodstream and skin infections. Gram-negative organisms were reported in approximately 75% of cases (78.7% extended-spectrum beta-lactamase (ESBL)-producers). Klebsiella pneumoniae was the commonest (51.0%), followed by Proteus mirabilis (21.3%) and Pseudomonas aeruginosa (10.6%). Methicillin-resistant Staphylococcus aureus (MRSA) (16%), and Clostridium difficile (9.6%) were the commonest among gram-positive bacteria.


CONCLUSIONS
Respiratory and urinary tract infections made up the great majority of NIs. ICU patients are more susceptible to NIs, emphasizing the importance of continuous surveillance and enforcement of specific infection control measures.
Department for Hygiene and Epidemiology Surveillance, University Clinical Center Tuzla, Tuzla, Bosnia and Herzegovina.
Amer
A
Custovic
Institute of Microbiology, Polyclinic for Laboratory Diagnostics, University Clinical Center Tuzla, Tuzla, Bosnia and Herzegovina.
Jasmina
J
Smajlovic
Department for Hygiene and Epidemiology Surveillance, University Clinical Center Tuzla, Tuzla, Bosnia and Herzegovina.
Sadeta
S
Hadzic
Infectious Diseases Hospital, University Clinical Center Tuzla, Tuzla, Bosnia and Herzegovina.
Sead
S
Ahmetagic
Institute of Microbiology, Polyclinic for Laboratory Diagnostics, University Clinical Center Tuzla, Tuzla, Bosnia and Herzegovina.
Nijaz
N
Tihic
The Clinic of Anesthesiology and Reanimation, University Clinical Center Tuzla, Tuzla, Bosnia and Herzegovina.
Haris
H
Hadzagic
ESBL-producing strains; nosocomial infections; surgical intensive care unit; surveillance