Nosocomial infections: current situation in a resuscitation-unit.

BACKGROUND: The nosocomial infection (NI) is defined as an infection that is not present or incubating on admission in establishment of care. It can be caused by the patient's germs, care personnel or hospital environment. Multidrug resistant (MDR) bacteria are particularly common in intensive care units that lead to a serious infections and increase morbidity, mortality and cost of care. PURPOSE: To identify the epidemiological characteristics of NI, the predisposing factors, the antimicrobial sensitivity pattern of isolated bacteria and the impact on morbidity and mortality. METHODS: Observational study over the year 2013. All infected patients hospitalized for at least 48 hours were included unless infection has been documented at admission. The type of sampling and bacteriological analyzes were performed based on the infection site according to the classification of Coordination Committee for the Fight against Nosocomial Infection of 2012. Statistical analysis was performed using the SPSS software 20. A p value <0.05 was considered significant. RESULTS: 63 patients were included with an average age of 51 years and SAPS II at 38. 95% of included patients were ventilated and 100% had a central catheterization. 164 infectious episodes were documented. The number of infection episodes per patient was statistically correlated with the length of stay. The most common isolated microorganism was Acinetobacter baumannii. It remains sensitive to colistin in 87.5% of cases. It was noted an emergence of Carbapenemase Producing Enterobacteriaceae (12%). The major identified risk factors were: previous organ failure, sepsis and catecholamines use (respective OR at 2.72, 2.56 and 2.15). Death was attributed to nosocomial infection in 36.6% of cases. CONCLUSION: The incidence of nosocomial infections is constantly rising in intensive care units. Pneumonia remains the most common infectious site. Contributing factors are an anterior organ failure, sepsis and catecholamines use. Approximately, one infected patient among three died by nosocomial infection.