Nosocomial infections in the Intesive care unit, University hospital for infectious and tropical diseases, Belgrade, Serbia

Abstract

Bacground/Aim. Nosocomial infections (NIs) are an important cause of morbidity, mortality and prolonged hospitalizations. Fifty percent of NIs have been reported in Intensive Care Units. The aim of this study was to determine the frequency and type of NIs among critically ill patients treated in the University Hospital for Infectious and Tropical Diseases, Clinical Centre of Serbia, as well as risk factors for acquiring them. Methods. This prospective cohort study included 52 patients treated in the Intensive Care Unit from January to June 2004. The diagnosis of NI was established according to the Centers for Disease Control and Prevention (CDC) definition, based on clinical presentation, radiological and microbiological findings, etc. Statistical data processing was done by using the electronic data base organized in SPSS for Windows version 10.0. The level of statistical significance was defined as p < 0. 05. Results. NIs were found in 33 (63.4%) of 52 inpatients. Urinary tract infections (UTIs), pneumonia, and soft tissue infections, the most common nosocomial infections in our setting, were recorded in 41.0%, 25.6%, and 23.1%, of patients, respectively. Several factors contributed to a high incidence of these infections: chronic comorbidities (p < 0.01), the presence of indwelling devices such as urinary tract catheters (p < 0.01), endotracheal tubes (p < 0.05) along with mechanical ventilation (p < 0.05). Conclusion. The majority of patients with NIs had chronic underlying comorbidities. All the patients with UTIs had urinary catheters. The most important risk factors for the development of nosocomial pneumonias were endotracheal intubation and mechanical ventilation. The patients with pneumonia had the highest mortality.Uvod/Cilj. Intrahospitalne infekcije su vazan uzrok morbiditeta i mortaliteta, kao i produzetka bolnickog lecenja. Polovina svih bolnickih infekcija javlja se u jedinicama intenzivne nege. Cilj ove studije bio je da se utvrde ucestalost i vrsta bolnickih infekcija kod bolesnika lecenih u Odeljenju intenzivne nege Klinike za infektivne i tropske bolesti Klinickog centra Srbije, kao i faktori rizika od obolevanja. Metode. Ovom prospektivnom kohortnom studijom bilo je obuhvaceno 52 bolesnika koji su leceni u Odeljenju intenzivne nege u Klinici za infektivne i tropske bolesti u periodu od januara do juna 2004. Dijagnoza je postavljana na osnovu definicije bolnickih infekcija Centra za kontrolu i prevenciju bolesti (CDC), klinicke slike, radioloskih, mikrobioloskih i drugih nalaza. Statisticka obrada podataka uradjena je pomocu statistickog paketa SPSS za Windows verziju 10.0. Nivo statisticke znacajnosti bio je p < 0,05. Rezultati. Intrahospitalne infekcije nadjene su kod 33 (63,4%) od ukupno 52 lecena bolesnika. Infekcije urinarnog trakta (41,0%), pneumonije (25,6%) i infekcije mekih tkiva (23,1%) bile su najcesce bolnicke infekcije. Nekoliko faktora doprinosilo je visokoj ucestalosti ovih infekcija: hronicne komorbidne bolesti (p < 0,01), prisustvo stalnih pomagala, kao sto su urinarni kateter (p < 0,01), endotrahealni tubus (p < 0,05), kao i mehanicka ventilacija (p < 0,05). Zakljucak. Vecina bolesnika sa bolnickim infekcijama imala je i neku hronicnu bolest. Svi bolesnici sa infekcijama urinarnog trakta imali su urinarni kateter. Najznacajniji faktori rizika od razvoja intrahospitalne pneumonije su endotrahealna intubacija i mehanicka ventilacija. Bolesnici sa pneumonijom imali su i najvecu smrtnost.