A Deptuła1, E Trejnowska2, G Dubiel3, M Żukowski4, A Misiewska-Kaczur5, T Ozorowski6, W Hryniewicz7. 1. Department of Microbiology, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Torun, Poland; Antimicrobial Stewardship and Infection Control Unit, Dr A. Jurasz University Hospital in Bydgoszcz, Poland. Electronic address: deptula.aleksander@gmail.com. 2. Department of Cardiac Anaesthesia and Intensive Care, Silesian Centre for Heart Diseases in Zabrze, Poland. 3. Anaesthesiology and Intensive Care Unit, Centre for Pulmonology and Thoracic Surgery in Bystra, Poland. 4. Department of Anaesthesiology, Intensive Care and Acute Poisoning, Pomeranian Medical University, Szczecin, Poland. 5. Anaesthesiology and Intensive Care Unit, Silesian Hospital in Cieszyn, Poland. 6. Department of Infection Control, Poznan University Hospital Przemienienia Panskiego, Poznan, Poland. 7. Division of Microbiology and Infection Prevention, National Medicines Institute, Warsaw, Poland.
Abstract
BACKGROUND: Infection is a major cause of morbidity and mortality in intensive care units (ICUs) worldwide. Local epidemiological studies need to be conducted to set the priorities for surveillance and prevention programmes. AIM: To investigate the epidemiology of hospital-acquired infections (HAIs) among patients admitted to Polish adult ICUs over a three-year period. METHODS: Data were collected according to the European Centre for Disease Prevention and Control (ECDC) European Union Point Prevalence Survey of Healthcare-associated Infections and Antimicrobial Use in European Acute Care Hospitals (EU-PPS HAI & AU) protocol for 39,318 patients within 160 acute care hospitals. From this initial database, data for adult ICU patients (N=945) were filtered for further analyses. FINDINGS: HAIs were present in 370 patients (39%) and 430 HAI episodes were recorded. The most common HAIs were respiratory tract infections (45%), usually caused by Enterobacteriaceae and Gram-negative non-fermenters. The majority (87%) of these infections were likely to be device associated. Out of 61 cases of bloodstream infection, 51% were catheter associated. These bloodstream infections were mainly caused by coagulase-negative staphylococci. Among 57 cases of surgical site infection, 42% were classified as organ/space, 33% were classified as deep incisional, and 25% were classified as superficial. The predominant micro-organisms were Enterobacteriaceae and Staphylococcus aureus. Out of 50 cases of urinary tract infection, 96% were device associated. CONCLUSIONS: The prevalence of HAI among Polish adult ICU patients is higher than described in similar studies, but may be partially affected by methodological differences. The proportion of device-associated infections was very high, so there is an urgent need to introduce countrywide, targeted surveillance and prevention programmes.
BACKGROUND:Infection is a major cause of morbidity and mortality in intensive care units (ICUs) worldwide. Local epidemiological studies need to be conducted to set the priorities for surveillance and prevention programmes. AIM: To investigate the epidemiology of hospital-acquired infections (HAIs) among patients admitted to Polish adult ICUs over a three-year period. METHODS: Data were collected according to the European Centre for Disease Prevention and Control (ECDC) European Union Point Prevalence Survey of Healthcare-associated Infections and Antimicrobial Use in European Acute Care Hospitals (EU-PPS HAI & AU) protocol for 39,318 patients within 160 acute care hospitals. From this initial database, data for adult ICUpatients (N=945) were filtered for further analyses. FINDINGS: HAIs were present in 370 patients (39%) and 430 HAI episodes were recorded. The most common HAIs were respiratory tract infections (45%), usually caused by Enterobacteriaceae and Gram-negative non-fermenters. The majority (87%) of these infections were likely to be device associated. Out of 61 cases of bloodstream infection, 51% were catheter associated. These bloodstream infections were mainly caused by coagulase-negative staphylococci. Among 57 cases of surgical site infection, 42% were classified as organ/space, 33% were classified as deep incisional, and 25% were classified as superficial. The predominant micro-organisms were Enterobacteriaceae and Staphylococcus aureus. Out of 50 cases of urinary tract infection, 96% were device associated. CONCLUSIONS: The prevalence of HAI among Polish adult ICUpatients is higher than described in similar studies, but may be partially affected by methodological differences. The proportion of device-associated infections was very high, so there is an urgent need to introduce countrywide, targeted surveillance and prevention programmes.