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Device-Associated Infections (Dais) in Icu: Using New Cdc/ Nhsn Definitions



Mohammadi M1 ; Seifi A2, 3 ; Mokhtaryan M2, 3 ; Ghahan A4 ; Ghaderkhani S2, 3 ; Mohammadnejad E5 ; Gheshlagh RG6
Authors
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Authors Affiliations
  1. 1. Department of Anesthesiology and Critical Care, School of Medicine, Tehran University of Medical Science, Tehran, Iran
  2. 2. Department of Infectious Diseases, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
  3. 3. Department of Infectious Diseases, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
  4. 4. Department of Nursing, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
  5. 5. Department of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
  6. 6. Social Determinants of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran

Source: Indian Journal of Forensic Medicine and Toxicology Published:2020

Abstract

Surveillance of device-associated infections (DAIs) in intensive-care units (ICUs) is essential for a suitable healthcare strategy-planning. This study was conducted to determine the DAIs rate, microbial epidemiology, and antimicrobial resistance pattern (AMR) in ICU. Three major DAIs, ventilator associated pneumonia (VAP), catheter-associated urinary tract infection (CAUTI), and central line-associated bloodstream infection (CLABSI) were assessed prospectively during 6 months (2018 March 21 to September 22) in an 18-bed ICU of a tertiary teaching hospital in Tehran according to new CDC/NHSN definitions for surveillance of DAIs. The incidence of VAP, CAUTI, and CLABSI were 38.2, 8.9, and 13.5 per 1000 device-days respectively. The most organisms were Acinetobacter baumannii (34.9%), Klebsiella pneumonia (19%), E.coli (10.7%), Candida (10.7%), Enterococcus Spp. (8.7%), Pseudomonas aeruginosa (8.7%), and Staphylococcus aureus (2.9%). Klebsiella pneumoniae carbapenemase (KPC)-producing was 47.4%. Acinetobacter resistance to Ampicillin-sulbactam and carbapenems was 80.6% and more than 90% respectively. Methicillin resistant Staphylococcus aureus (MRSA) was 66.6% and Vancomycin-resistant Enterococcus (VRE) was 88.9%. This study showed high incidence of DAIs and resistant organisms in the ICU. Preventive measures are essential to decrease the rates. © 2020, Indian Journal of Forensic Medicine and Toxicology. All rights reserved.
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