FREQUENCY, PATTERN AND ETIOLOGY OF NOSOCOMIAL INFECTION IN INTENSIVE CARE UNIT: AN EXPERIENCE AT A TERTIARY CARE HOSPITAL
Abstract
Background: Nosocomial infection is defined as an infection which develops 48 hours afterhospital admission or within 48 hours after being discharged. The objectives were to assess the
frequency of nosocomial infection in patients admitted to intensive care unit (ICU) and to
determine the etiological factors in such patients. It was an Observational Study and conducted in
Intensive Care Unit, Liaquat University Hospital Hyderabad Sindh Pakistan from January 2008 to
November 2008. Methods: All patients above 16 years of age admitted in the ICU for more than
48 hours and developed clinical evidence of infection that did not originate from patients' original
diagnosis at the time of admission, were included in the study. Data was entered in a proforma and
analyzed using SPSS version 10.0. Results: During the study period, 97 out of 333 patients
acquired nosocomial infection. The frequency of nosocomial infection was 29.13%. Respiratory
tract infection was seen in 29 (30.1%), urinary tract infection in 38 (39.1%) and blood stream
infection in 23 (23.7%) patients. Other infections we identified were skin, soft tissue, wound and
gastrointestinal tract infections. Conclusion: Patients admitted in intensive care unit are at more
risk of acquiring nosocomial infection from different sources. It is suggested that proper nursing
care, sterilization and disinfection of instruments and equipment and careful handling of invasive
procedures are the best tool to control these life threatening infections.
Keywords: intensive care unit, Nosocomial infection, Hospital acquired infection
References
Costantini M, Donisi PM, Turrin MG, Diana L. Hospital
acquired infection surveillance and control in intensive care
services: Results of an incidence study. Eur J Epidemiol,
;3:347-55.
Ferrer M, Valencia M, Torres A. Management of Ventilator
associated pneumonia. In: Vincent JL. 2008 Year Book of
Intensive Care and Emergency Medicine. Verlag Berlin
Heidelberg: Springer, 2008;p.353-64.
Craven DE, Kunches LM, Lichtenberg DA, Kollisch NR,
Barry MA, Heeren TC et al. Nosocomial infection and
fatality in medical and surgical intensive care unit patients.
Arch Intern Med, 1988;148(5):1161-8.
Vincent JL, Bihari DJ, Suter PM, Bruining HA, White J,
Nicolas-Chanoin MH, et al. The prevalence of nosocomial
infection in intensive care units in Europe. Results of The
European Prevalence of Infection in Intensive Care (EPIC)
Study. EPIC International Advisory Committee. JAMA,
;274:639-44.
Tablan OC, Anderson LJ, Besser R, Bridges C, Hajjeh R.
Guidelines for preventing health-care-associated pneumonia,
: Recommendations of the CDC and the Healthcare
Infection Control Practice Advisory Committee. MMWR
Recomm Rep, 2004;53:1-36.
O'Grady NP, Alexander M, Dellinger EP, Gerberding JL,
Heard SO, Maki GD. Guidelines for the prevention of
intravascular catheter related infections. Infect Control Hosp
Epidemiol, 2002;23:759-69.
Shannon SC. Chronic critical illness. In Jesse BH, Gregory
AS, Lawrence DH, eds. Principles of Critical Care. 3rdEd,
McGraw Hill, 2005;p. 207-15.
Richards MJ, Edwards JR, Culver DH, Gaynes RP.
Nosocomial infections in medical intensive care units in the
United States. National Nosocomial Infections Surveillance
System. Crit Care Med, 1999;27:887-92.
Rizvi MF, Hasan Y, Memon AR, Abdullah M, Rizvi MF,
Saleem S, et al. Pattern of nosocomial infection in two
intensive care units of a tertiary care hospital in Karachi. J
Coll Physicians Surg Pak, 2007;17:136-9.
Richards MJ, Edwards JR, Culver DH, Gaynes RP.
Nosocomial infections in combined medical-surgical
intensive care units in the United States. Infect Control Hosp
Epidemiol, 2000;21:510-5.
Laupland KB, Zygun DA, Davies HD, Church DL, Louie TJ,
Doig CJ. Incidence and risk factors for acquiring nosocomial
urinary tract infection in the critically ill. J Crit Care,
;17:50-7.
Erbay H, Yalcin AN, Serin S, Turgut H, Tomatir E, Cetin B,
et al. Nosocomial infections in intensive care unit in a
Turkish university hospital: a 2-year survey. Intensive Care
Med, 2003;29:1482-8.
Finkelstein R, Rabino G, Kassis I, Mahamid I. Deviceassociated, device-day infection rates in an Israeli adult
general intensive care unit. J Hosp Infect, 2000;44:200-5.
Rosser CJ, Bare RL, Meredith JW. Urinary tract infections in
the critically ill patient with a urinary catheter. Am J Surg,
;177:287-90.
Jean YF, Jean C. Nosocomial Pneumonia. In Mitchell PF,
Edward A, Vincent JL, Patrick MK, (eds.) Text Book of
Critical Care. 5th Ed. Elsevier 2005;p.663-77.
American Thoracic Society and Infectious Diseases Society
of America. Guidelines for the management of adults with
hospital acquired, ventilator-associated and healthcareassociated pneumonia. Am J Respir Crit Care Med,
;171:388-416.
Chastre J, Wolff M, Fagon JY, Chevret S, Thomas F,
Wermert D, et al. Comparison of 8 vs. 15 days of antibiotic
therapy for ventilator-associated pneumonia in adults: a
randomized trial. JAMA, 2003;29:2558-98.
Rello J, Ollendorf DA, Oster G, Vera LM, Bellm L, Redman
R, et al. Epidemiology and outcomes of ventilator-associated
pneumonia in a large US database. Chest, 2002;122:2115-21.
Cook DJ, Walter SD, Cook RJ, Griffith LE, Guyatt GH,
Leasa D, et al. Incidence of and risk factors for ventilator
associated pneumonia in critically ill patients. Ann Intern
Med, 1998;129:433-40.
Marra AR, Wey SB, Castelo A, Gales AC, Cal RG, Filho JR,
et al. Nosocomial bloodstream infections caused by
Klebsiella pneumoniae: impact of extended spectrum β-
lactamase (ESBL) production on clinical outcome in a
hospital with high ESBL prevalence. BMC Infect Dis,
;14(6):24.
Pfaller MA, Jones RN, Doern GV, Kugler K.. Bacterial
pathogens isolated from patients with bloodstream infection:
frequencies of occurrence and antimicrobial susceptibility
patterns from the SENTRY antimicrobial surveillance
program (United States and Canada, 1997). Antimicrob
Agents Chemother, 1998;42:1762-70.
Wanga KW, Chang WN, Huang CR, Tsai NW, Tsui HW,
Wang HC, et al. Post urosurgical nosocomial bacterial
meningitis in adults: microbiology, clinical features, and
outcomes. J Clin Neurosci, 2005;12:647-50.
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