Shirin Afhami1, Arash Seifi2, Mahboubeh Hajiabdolbaghi2, Negin Esmailpour Bazaz1, Azar Hadadi3, Mehrdad Hasibi4, Parvin Rezaie5, Esmail Mohamadnejad6, Azam Ghahan6, Mitra Hajinoori7, Fatemeh Veyceh8, Shahnaz Adinehkharrat6, Zahraparvin Hojjati6, Zohre Azimbeik8. 1. Department of Infectious Diseases, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Islamic Republic of Iran. 2. Department of Infectious Diseases, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Islamic Republic of Iran. 3. Department of Infectious Diseases, Sina Hospital, Tehran University of Medical Sciences, Tehran, Islamic Republic of Iran. 4. Department of Infectious Diseases, Amir Alam Hospital, Tehran University of Medical Sciences, Tehran, Islamic Republic of Iran. 5. Department of Nursing, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Islamic Republic of Iran. 6. Department of Nursing, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Islamic Republic of Iran. 7. Department of Nursing, Amir Alam Hospital, Tehran University of Medical Sciences, Tehran, Islamic Republic of Iran. 8. Department of Nursing, Sina Hospital, Tehran University of Medical Sciences, Tehran, Islamic Republic of Iran.
Abstract
BACKGROUND: Surveillance of health care-associated infections (HCAIs) is an integral part of infection control programmes, especially in intensive care units (ICUs). Device-associated infections (DAIs) are a major threat to patient safety. AIM: To measure DAI rates in ICUs. METHODS: Central line-associated bloodstream infection (CLABSI), ventilator-associated pneumonia (VAP), and catheter- associated urinary tract infection (CAUTI) were assessed in the ICUs of 4 tertiary-care teaching hospitals in Tehran, Islamic Republic of Iran. RESULTS: The incidence rate of CLABSI, VAP and CAUTI was 10.20, 21.08 and 7.42 per 1000 device-days, respectively. The utilization ratio for central lines, ventilators and urinary catheters was 0.62, 0.47, and 0.84, respectively. The most common organisms were Acinetobacter (33.5 %) and Klebsiella (19.0 %). Sixty to eighty percent of Enterobacteriaceae were extended- spectrum beta-lactamase producing. About half of Pseudomonas aeruginosa isolates were resistant to piperacillin/ tazobactam and carbapenem. Acinetobacter resistance rate to ampicillin/sulbactam and carbapenem was 70-80 %. The prevalence of methicillin-resistant Staphylococcus aureus and vancomycin-resistant Enterococcus was 84.6 % and 83.3 %, respectively. CONCLUSIONS: This study showed high incidence rates of DAIs and resistant organisms, and appropriate interventions are necessary to reduce these rates.
BACKGROUND: Surveillance of health care-associated infections (HCAIs) is an integral part of infection control programmes, especially in intensive care units (ICUs). Device-associated infections (DAIs) are a major threat to patient safety. AIM: To measure DAI rates in ICUs. METHODS: Central line-associated bloodstream infection (CLABSI), ventilator-associated pneumonia (VAP), and catheter- associated urinary tract infection (CAUTI) were assessed in the ICUs of 4 tertiary-care teaching hospitals in Tehran, Islamic Republic of Iran. RESULTS: The incidence rate of CLABSI, VAP and CAUTI was 10.20, 21.08 and 7.42 per 1000 device-days, respectively. The utilization ratio for central lines, ventilators and urinary catheters was 0.62, 0.47, and 0.84, respectively. The most common organisms were Acinetobacter (33.5 %) and Klebsiella (19.0 %). Sixty to eighty percent of Enterobacteriaceae were extended- spectrum beta-lactamase producing. About half of Pseudomonas aeruginosa isolates were resistant to piperacillin/ tazobactam and carbapenem. Acinetobacter resistance rate to ampicillin/sulbactam and carbapenem was 70-80 %. The prevalence of methicillin-resistant Staphylococcus aureus and vancomycin-resistant Enterococcus was 84.6 % and 83.3 %, respectively. CONCLUSIONS: This study showed high incidence rates of DAIs and resistant organisms, and appropriate interventions are necessary to reduce these rates.