Nosocomial infections encountered in the anesthesiology intensive care unit

Abstract

Objective: The aim of this study was to determine the types of nosocomial infections, pathogens, and their antimicrobial resistance patterns in patients admitted to the Anesthesiology Intensive Care Unit of Medicine Faculty of Pamukkale University.

Materials and methods: The study was performed within a six-month period in 117 patients (69 men, 48 women; mean age 61 18 years) who stayed at our intensive care unit for more than 48 hours and had no signs of infection on admission. The patients were followed-up prospectively by a laboratory-and patient-based active surveillance system. Diagnosis of nosocomial infections was based on the criteria of the Centers for Disease Control and Prevention.

Results: Sixty-one patients (52.1%) developed 89 episodes of nosocomial infections. The infection rate was 38.5% among all the patients admitted to our intensive care unit in the same period. The types of infections were as follows: ventilator-associated pneumonia (42 episodes, 47.2%), bloodstream infections (n=20, 22.5%), urinary tract infections (n=14, 15.7%), catheter-related infections (n=7, 7.9%), and surgical site infections (n=6, 6.7%). A total of 121 pathogens were isolated, including gram-positive bacteria (n=38, 31.4%), gram-negative bacteria (n=69, 57%), and Candida spp. and Aspergillus spp. (n=14, 11.6%). The most frequently isolated five pathogens were Pseudomonas aeruginosa (25.1%), Acinetobacter baumannii (17.4%), Staphylococcus aureus (15.7%), coagulase-negative staphylococci (12.4%), and Candida spp. (10.7%). Resistance to methicillin was 84.6% among S. aureus isolates, with none being resistant to vancomycin. The lowest resistance rate in P. aeruginosa strains was against amikacin (21%), while the most susceptible antibiotics were netilmicin (69.3%) and trimethoprimsulfannethoxazole (61.6%) for A. baumannii isolates.

Conclusion: Nosocomial infection surveillance studies should be performed meticulously in intensive care units and new and effective infection control policies should be developed with a multidisciplinary approach.