Epidemiologic surveillance of nosocomial infections in a mixed intensive care unit of a university hospital

  • Dan Pu, Department of Infection control, West China Hospital, Sichuan University, China
  • zhiyong zong, Center of Infectious Diseases, West China Hospital, Sichuan University, China
  • weidong zhang, Department of Infection control, West China Hospital, Sichuan University, China
  • cheng tan, Department of Infection control, West China Hospital, Sichuan University, China
  • mingrong shu, Department of Infection control, West China Hospital, Sichuan University, China
  • baohua liu, Department of Infection control, West China Hospital, Sichuan University, China
  • baoyu yang, Department of Infection control, West China Hospital, Sichuan University, China

Background: Healthcare-associated infections (HCAIs) impact 10% of hospitalized patients. The purpose of this study was to determine the risk factors, incidence, and etiology of nosocomial infections (NIs) of our hospital in order to improve our infection control policies in the mixed intensive care unit (ICU) from a developing country.
Methods: We performed a prospective cohort study of NI surveillance during 8 months in a 52-bed mixed intensive care unit of a 4500-bed university hospital in 2010.
Results: Out of 1129 patients hospitalized in the ICU for a period of 11238 days,248 patients acquired a total of 265 NIs distributed as follows: 49.5% ventilator-associated pneumonia (VAP), 20.5% bacteremia, 8% coeliac infection,6.4% central-line infection, 5.8% catheter-associated urinary tract infection, 3.9% cutaneous infection, 3.1% antibiotic dependence diarrhea and 2.8% Enteral infection. The incidence rate of NI was 23.6 in 1000 patient-days, and the rate of NI was 28.6%. Mechanical ventilation tracheostomy, central venous catheterization and length of ICU stay were statistically significant risk factors for NI. Of all NI.212 (80%) were microbiologically-confirmed and 78.7% of the isolates were Gram-negative, 11.8% were fungi and 9.5% were Gram-positive. 53 (20%) were clinically-defined infections. The most frequently isolated organism was A. baumannii (48.5%), followed by P. aeruginosa (19.9%) and fungi(11.8%).
Conclusions: The ventilator-associated pneumonia was the most common site and Gram-negatives were the most commonly causes of ICU infections.