title: Incidence, Clinical Outcome and Risk Factors of Intensive Care Unit Infections in the Lagos University Teaching Hospital (LUTH), Lagos, Nigeria.
abstract: BACKGROUND
  Infections are common complications in critically ill patients with associated significant morbidity and mortality.
  
  
  OBJECTIVE
  This study determined the prevalence, risk factors, clinical outcome and microbiological profile of hospital-acquired infections in the intensive care unit of a Nigerian tertiary hospital.
  
  
  METHODS
  This was a prospective cohort study, patients were recruited and followed up between September 2011 and July 2012 until they were either discharged from the ICU or died. Antimicrobial susceptibility testing of isolates was done using CLSI guidelines.
  
  
  RESULTS
  Seventy-one patients were recruited with a 45% healthcare associated infection rate representing an incidence rate of 79/1000 patient-days in the intensive care unit. Bloodstream infections (BSI) 49.0% (22/71) and urinary tract infections (UTI) 35.6% (16/71) were the most common infections with incidence rates of 162.9/1000 patient-days and 161.6/1000 patient-days respectively. Staphylococcus aureus was the most common cause of BSIs, responsible for 18.2% of cases, while Candida spp. was the commonest cause of urinary tract infections, contributing 25.0% of cases. Eighty percent (8/10) of the Staphylococcus isolates were methicillin-resistant. Gram-negative multidrug bacteria accounted for 57.1% of organisms isolated though they were not ESBL-producing. Use of antibiotics (OR = 2.98; p = 0.03) and surgery (OR = 3.15, p< 0.05) in the month preceding ICU admission as well as urethral catheterization (OR = 5.38; p<0.05) and endotracheal intubation (OR = 5.78; p< 0.05) were risk factors for infection.
  
  
  CONCLUSIONS
  Our findings demonstrate that healthcare associated infections is a significant risk factor for ICU-mortality and morbidity even after adjusting for APACHE II score.
authors: Department of Medical Microbiology and Parasitology, College of Medical Sciences, University of Calabar, Calabar, Nigeria.
authors: Anthony A
authors: AA
authors: Iwuafor
authors: Department of Medical Microbiology and Parasitology, College of Medicine, University of Lagos, Nigeria.
authors: Folasade T
authors: FT
authors: Ogunsola
authors: Department of Medical Microbiology and Parasitology, College of Medicine, University of Lagos, Nigeria.
authors: Rita O
authors: RO
authors: Oladele
authors: Department of Medical Microbiology and Parasitology, College of Medicine, University of Lagos, Nigeria.
authors: Oyin O
authors: OO
authors: Oduyebo
authors: Department of Anaesthesia, College of Medicine, University of Lagos, Nigeria.
authors: Ibironke
authors: I
authors: Desalu
authors: Department of Medical Microbiology and Parasitology, Faculty of Medicine, Nnamdi Azikiwe University, Nnewi Campus, Awka, Nigeria.
authors: Chukwudi C
authors: CC
authors: Egwuatu
authors: Department of Immunology, Faculty of Medicine, Nnamdi Azikiwe University, Nnewi Campus, Awka, Nigeria.
authors: Agwu U
authors: AU
authors: Nnachi
authors: Department of Medical Microbiology and Parasitology, Faculty of Medicine, Nnamdi Azikiwe University, Nnewi Campus, Awka, Nigeria.
authors: Comfort N
authors: CN
authors: Akujobi
authors: Department of Medical Microbiology and Parasitology, College of Medical Sciences, University of Calabar, Calabar, Nigeria.
authors: Ita O
authors: IO
authors: Ita
authors: Department of Medical Microbiology and Parasitology, College of Medical Sciences, University of Calabar, Calabar, Nigeria.
authors: Godwin I
authors: GI
authors: Ogban
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D003428:Cross Infection / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology / Q000473:pathology; D004352:Drug Resistance, Microbial; D006785:Hospitals, University / Q000458:organization & administration*; D006801:Humans; D015994:Incidence; D007362:Intensive Care Units; D008826:Microbial Sensitivity Tests; D009549:Nigeria; D011446:Prospective Studies; D012307:Risk Factors
chemical_list: D000900:Anti-Bacterial Agents