An observational case study of hospital associated infections in a critical care unit in Astana, Kazakhstan

Abstract

BackgroundHospital Associated infections (HAI) are very common in Intensive Care Units (ICU) and are usually associated with use of invasive devices in the patients. This study was conducted to determine the prevalence and etiological agents of HAI in a Surgical ICU in Kazakhstan, and to assess the impact of these infections on ICU stay and mortality.ObjectiveTo assess the rate of device-associated infections and causative HAI etiological agents in an ICU at the National Research Center for Oncology and Transplantation (NRCOT) in Astana, Kazakhstan.MethodsThis retrospective, observational study was conducted in a 12-bed ICU at the NRCOT, Astana, Kazakhstan. We enrolled all patients who were admitted to the ICU from January, 2014 through November 2015, aged 18 to 90 years of age who developed an HAI.ResultsThe most common type of HAI was surgical site infection (SSI), followed by ventilator-associated pneumonia (VAP), catheter-related blood stream infection (BSI) and catheter-associated urinary tract infection (UTI). The most common HAI was SSI with Pseudomonas aeruginosa as the most common etiological agent. The second most common HAI was VAP also with P. aeruginosa followed by BSI which was also associated with P. aeruginosa (in 2014) and Enterococcus faecalis, and Klebsiella pneumoniae (in 2015) as the most common etiological agents causing these infections.ConclusionWe found that HAI among our study population were predominantly caused by gram-negative pathogens, including P. aeruginosa, K. pneumoniae, and E. coli. To our knowledge, this is the only study that describes ICU-related HAI situation from a country within the Central Asian region. Many developing countries such as Kazakhstan lack surveillance systems which could effectively decrease incidence of HAIs and healthcare costs for their treatment. The epidemiological data on HAI in Kazakhstan currently is underrepresented and poorly reported in the literature. Based on this and previous studies, we propose that the most important interventions to prevent HAI at the NRCOT and similar Healthcare Institutions in Kazakhstan are active surveillance, regular infection control audits, rational and effective antibacterial therapy, and general hygiene measures.

An interactive nomogram to predict healthcare-associated infections in ICU patients: A multicenter study in GuiZhou Province, China

“…In our study, HCAIs were mainly caused by gram-negative pathogens. Viderman et al and Kolpa et al also obtained similar results [10, 42]. AB (43.15%) and Staphylococcus aureus (10.15%) accounted for the highest proportions of gram-negative and gram-positive bacteria, respectively, which is consistent with the results of Kolpa et al [42] The winter and spring seasons showed the highest incidence rates of HCAIs.…”

“…Previous studies have reported that independent factors affecting HCAIs include diabetes, chronic obstructive pulmonary disease and obesity [9, 10]. However, Teerawattanapong et al did not find any links between these chronic diseases and HCAI, but instead observed that mechanical ventilation, antibiotic use, the presence of indwelling catheters and patient age were more likely contributing factors to the development of HCAIs [11].…”

Hospital-acquired infections caused by enterococci: a systematic review and meta-analysis, WHO European Region, 1 January 2010 to 4 February 2020

“…Fourteen studies reported [ 6 , 53 , 55 , 59 , 62 , 63 , 68 , 69 , 72 , 75 , 81 , 82 , 84 , 85 ] data on the incidence of HAI caused by Enterococcus spp. in ICU.…”

Knowledge and Perception on Prevention of Hospital Acquired Infections (HAI) among Health Care Professionals in Tertiary Care Teaching Hospital

“…Hospitals around the world, health workers are playing a major role in treating patients with health-related problems and infections. Hospital-acquired infections (HAIs) are the major challenge across the globe as the HAIs markedly influence the quality of health care delivery, mainly by adding burden to the underdeveloped and developing countries 1 . The main mode of transmission of HAIs is from patient to patient through health care professionals who did not follow the standard precautions 2 .…”