title: Mortality among Patients with Nosocomial Infections in Tertiary Intensive Care Units of Sahloul Hospital, Sousse, Tunisia.
abstract: BACKGROUND
  Nosocomial infections are public health issues that are associated with high mortality in intensive care units. This study aimed to determine nosocomial infection-associated mortality in Tunisian intensive care units and identify its risk factors.
  
  
  METHODS
  A prospective cohort study was carried out in intensive care units of a Tunisian University Hospital. The ICUs-wide active surveillance of nosocomial infections has been performed between 1 July 2010 and 30 June 2011. Data collection was based on Rea-Raisin protocol 2009 of "Institut National de Veille Sanitaire" (InVS, Saint Maurice - France). We used Kaplan Meier survival analysis and Cox Proportional Hazard regression to identify independent risk factors of nosocomial infection-associated mortality.
  
  
  RESULTS
  Sixty-seven patients presented nosocomial infection in the end of the surveillance. The mean age of patients was 44.71 ± 21.2 years. Of them, 67.2% were male and 32.8% female. Nosocomial bacteremia was the most frequent infection (68.6%). Nosocomial infection-associated mortality rate was 35.8% (24/67). Bacteremia (Hazard Ratio (HR)) = 3.03, 95% Confidential Interval (95% CI): [1.23 - 7.45], P = 0.016) and trauma (HR = 3.6, 95% CI: [1.16 - 11.2], P = 0.026) were identified by Cox regression as independent risk factors for NI-associated mortality.
  
  
  CONCLUSIONS
  Our rate was relatively high. We need to improve the care of trauma patients and intensify the fight against nosocomial infections especially bacteremia.
authors.affiliation: Department of Prevention and Care Safety, Hospital of Sahloul, Route Ceinture Sahloul, Sousse, Tunisia. mohamed_benrejeb@yahoo.fr, mohamed.benrejeb@rns.tn.
authors.forename: Mohamed Ben
authors.initials: MB
authors.lastname: Rejeb
authors.affiliation: Department of Prevention and Care Safety, Hospital of Sahloul, Route Ceinture Sahloul, Sousse, Tunisia.
authors.forename: Jihene
authors.initials: J
authors.lastname: Sahli
authors.affiliation: Department of Prevention and Care Safety, Hospital of Sahloul, Route Ceinture Sahloul, Sousse, Tunisia.
authors.forename: Dhekra
authors.initials: D
authors.lastname: Chebil
authors.affiliation: Department of Prevention and Care Safety, Hospital of Sahloul, Route Ceinture Sahloul, Sousse, Tunisia.
authors.forename: Selwa
authors.initials: S
authors.lastname: Khefacha-Aissa
authors.affiliation: Department of Prevention and Care Safety, Hospital of Sahloul, Route Ceinture Sahloul, Sousse, Tunisia.
authors.forename: Nadia
authors.initials: N
authors.lastname: Jaidane
authors.affiliation: Department of Prevention and Care Safety, Hospital of Sahloul, Route Ceinture Sahloul, Sousse, Tunisia.
authors.forename: Balsam
authors.initials: B
authors.lastname: Kacem
authors.affiliation: Department of Medical Intensive Care, Hospital of Sahloul, Route Ceinture Sahloul, Sousse, Tunisia.
authors.forename: Houssem
authors.initials: H
authors.lastname: Hmouda
authors.affiliation: Department of Prevention and Care Safety, Hospital of Sahloul, Route Ceinture Sahloul, Sousse, Tunisia.
authors.forename: Lamine
authors.initials: L
authors.lastname: Dhidah
authors.affiliation: Department of Prevention and Care Safety, Hospital of Sahloul, Route Ceinture Sahloul, Sousse, Tunisia.
authors.forename: Houyem
authors.initials: H
authors.lastname: Said-Latiri
authors.affiliation: Department of Surgical Intensive Care, Hospital of Sahloul, Route Ceinture Sahloul, Sousse, Tunisia.
authors.forename: Walid
authors.initials: W
authors.lastname: Naija
mesh_terms: D000328:Adult; D000368:Aged; D016470:Bacteremia / Q000453:epidemiology*; D003428:Cross Infection / Q000401:mortality*; D005260:Female; D006785:Hospitals, University; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data*; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D061214:Patient Safety; D000091402:Prohibitins; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors; D014416:Tunisia; D055815:Young Adult