Reanimasyon ünitesinde on yıllık sürede gelişen hastane enfeksiyonlarının değerlendirilmesi ve literatürün gözden geçirilmesi

Objectives: Hospital acquired infections (HAI) are major health problem in intensive care units. We aimed to determine the nosocomial infection rate, distribution of HAI and the distribution of microorganisms isolated from nosocomial infections and their antibiotic resistance profiles in hospitalized patients in intensive care unit. Materials and methods: A total 222 patients with a diagnosis of hospital-acquired infection hospitalized between January 2003 and June 2012 at Dicle University Medical Faculty Hospital intensive care unit, were included in this study. Clinical, radiographic, laboratory data and culture results recorded to the standard forms and in the computer environment on a daily basis. Hospital acquired infections rates by year, distribution of HAI according to the systems, infectious agents were determined. Results: A total of 327 episodes of HAI were developed 222 (18.4%) of 1208 hospitalized patients in ten years period per 21 974 patients day. Hospital-acquired infection rate was 27.6 per 100 patient days and density was 15.2 per 1000 patient days. The most common HAI were bloodstream infection (38.5%) and followed by pneumonia (24%) and ventilator-associated pneumonia (14.7%). Acinetobacter spp. (23.7%) and Pseudomonas aeruginosa (13.9%) were the most frequently isolated bacteria. The most effective antibiotics against gram-negative microorganisms were colistin, amikacin, imipenem, meropenem, cefoperazone-sulbactam, while gram-positives to linezolid, vancomycin and daptomycin. Conclusion: Prolonged duration of hospitalization increases the risk of infection and invasive procedures. Prevention of unnecessary invasive procedures, early removal of invasive catheters, infection control measures and documenting of antibiotic susceptibilities of causative organisms will reduce the incidence of HAI.