Hospital-acquired Infections in the Adult Intensive Care Unit: Epidemiology, Resistance Patterns, and Risk Factors.

Abstract

Introduction: Hospital-acquired infections (HAIs) are defined as infections that develop in the patient after being admitted to the hospital. The overall burden of HAIs is known to be higher in developing countries. The most common HAIs include ventilator-associated pneumonia (VAP), catheter-associated urinary tract infection (CAUTI), surgical site infection (SSI), and catheter-related bloodstream infections (CRBSI).

Objectives: Due to limited recent literature, we aimed to evaluate the incidence rates and causative organisms of intensive care unit (ICU)-acquired infections at our tertiary care center and to determine the factors associated with mortality in patients with ICU-acquired infections.

Methods: Single-center prospective, observational study.

Results: The incidence rates in our study were: VAP incidence rate: 105/2681 = 39.1/1000 ventilator days, CRBSI incidence rate: 38/4871 = 7.8/1000 central venous catheter (CVC) days, CAUTI incidence rate: 54/11201 = 4.8/1000 urinary catheter days. Acinetobacter baumannii accounted for 41% of the infections in patients with VAP and 21% in patients with CRBSI. E. coli was the most common causative organism in the CAUTI group, accounting for 33% of the infections. Age >50 years, presence of hypotension on presentation, medical diagnosis, multiple ICU-acquired infections, and higher APACHE-II score on admission are the statistically significant determinants of the incidence of mortality in the overall group (p-value >0.05 for all).

Conclusion: Age >50 years, presence of hypotension on presentation, medical diagnosis, multiple ICU-acquired infections, and higher APACHE-II score on admission must be kept in mind as determinants of the incidence of mortality in HAIs.