Evaluation of Healthcare-Associated Infections in Intensive Care Units

Abstract

Aim: The aim of this study was to determine the healthcare-associated infections (HAIs), causative microorganisms and antibiotic resistance profiles in the tertiary intensive care unit of our hospital and, based on the results, to contribute to the rational administration of antibiotics. Material and Method: The study included patients who were followed up in the tertiary intensive care unit between January 2023 and December 2023 and were diagnosed with HAI. Patient data were obtained retrospectively from infection control nurse records and patient files. Results: During the study period, 107 HAI episodes were identified in 99 of 2296 patients. The incidence rate of HAI was 4.7% and the incidence density was 5.2 per thousand. Central line-associated bloodstream infections (43%) were the most common HAI associated with invasive devices. The next most common were ventilator-associated pneumonia (42%) and catheter-associated urinary tract infection (15%). Gram negative bacteria were isolated in 83.2%, fungi in 10.3%, and gram positive bacteria in 6.5% of patients diagnosed with HAI. The most common gram negative bacteria were Acinetobacter baumannii (34.6%) and Pseudomonas aeruginosa (19.6%). A colistin resistance rate of 8.1% was determined for Acinetobacter baumannii. Carbapenem resistance was 91.9% for Acinetobacter baumannii and 76.2% for Pseudomonas aeruginosa. Methicillin resistance was found in 66.7% of Staphylococcus aureus, the most commonly isolated gram positive bacterium. Conclusion: Monitoring HAIs, causative microorganisms and antibiotic resistance rates in intensive care units is of great importance for both infection prevention and the rational use of antibiotics.