National Infection Control Program in Turkey: The healthcare associated infection rate experiences over 10 years

Gözel, Mustafa Gökhan; Hekimoğlu, Can Hüseyin; Gozel, Emine Yildirim; Batir, Esen; McLaws, Mary‐Louise; Meşe, Emine Alp

doi:10.1016/j.ajic.2020.12.013

Cited by 14 publications

(13 citation statements)

References 24 publications

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“…According to the data, device-related infection rates in a multicenter study from Turkey were 4.86–16.69 per 1000 device-days for ventilator-related events, 1.59–4.98 for catheter-related urinary tract infections, and 2.82–5.65 for BSIs, respectively. 13 According to our data, the rates of VAP, CLA-BSIs, and CA-UTIs in ICUs were 11.57, 4.00, and 1.99 per 1000 device-days, respectively. It has been seen that our results are in the average Turkey values.…”

Section: Discussionmentioning

confidence: 61%

A 5-year surveillance of healthcare-associated infections in a university hospital: A retrospective analysis

et al. 2022

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Objectives: “Nosocomial infections” or “healthcare-associated infections” are a significant public health problem around the world. This study aimed to assess the rate of laboratory-confirmed healthcare-associated infections, frequency of nosocomial pathogens, and the antimicrobial resistance patterns of bacterial isolates in a University Hospital. Methods: A retrospective evaluation of healthcare-associated infections in a University Hospital, between the years 2015 and 2019 in Tekirdag, Turkey. Results: During the 5 years, the incidence densities of healthcare-associated infections in intensive care units and clinics were 10.31 and 1.70/1000 patient-days, respectively. The rates of ventilator-associated pneumonia, central line–associated bloodstream infections, and catheter-associated urinary tract infections in intensive care units were 11.57, 4.02, and 1.99 per 1000 device-days, respectively. The most common healthcare-associated infections according to the primary sites were bloodstream infections (55.3%) and pneumonia (20.4%). 67.5% of the isolated microorganisms as nosocomial agents were Gram-negative bacteria, 24.9% of Gram-positive bacteria, and 7.6% of Candida. The most frequently isolated causative agents were Escherichia coli (16.7%) and Pseudomonas aeruginosa (15.7%). The rate of extended-spectrum beta-lactamase production among E. coli isolates was 51.1%. Carbapenem resistance was 29.8% among isolates of P. aeruginosa, 95.1% among isolates of Acinetobacter baumannii, and 18.2% among isolates of Klebsiella pneumoniae. Colistin resistance was 2.4% among isolates of A. baumannii. Vancomycin resistance was 5.3% among isolates of Enterococci. Conclusion: Our study results demonstrate that healthcare-associated infections are predominantly originated by intensive care units. The microorganisms isolated from intensive care units are highly resistant to many antimicrobial agents. The rising incidence of multidrug-resistant microorganisms indicates that more interventions are urgently needed to reduce healthcare-associated infections in our intensive care units.

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Section: Discussionmentioning

confidence: 61%

A 5-year surveillance of healthcare-associated infections in a university hospital: A retrospective analysis

et al. 2022

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“…Nowadays, such infections are significant problems for societies and healthcare organizations. They prolong the treatment period and make both patients and health centers pay excessive costs, including increased drug intakes and tests [5]. Therefore, by preventing and reducing nosocomial infections, significant savings will be made in the costs imposed on health centers, the health system and society consequently [6].…”

Section: Introductionmentioning

confidence: 99%

“…Medical interventions, poor health standards of the hospital environment, and poor personal hygiene of hospital staff and patients poor practice of personal hygiene among hospital staff and patients can cause HAIs [16]. However, the major/leading cause of HAIs is lack of compliance to health and safety guidelines of hospitals [17]. Although it is impossible to eliminate such infections even in the most advanced hospitals, standards and guidelines can be complied with the intention of reducing or managing them [18,19].…”

Section: Introductionmentioning

confidence: 99%

Global prevalence of nosocomial infection: A systematic review and meta-analysis

et al. 2023

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Objectives Hospital-acquired infections (HAIs) are significant problems as public health issues which need attention. Such infections are significant problems for society and healthcare organizations. This study aimed to carry out a systematic review and a meta-analysis to analyze the prevalence of HAIs globally. Methods We conducted a comprehensive search of electronic databases including EMBASE, Scopus, PubMed and Web of Science between 2000 and June 2021. We found 7031 articles. After removing the duplicates, 5430 studies were screened based on the titles/ abstracts. Then, we systematically evaluated the full texts of the 1909 remaining studies and selected 400 records with 29,159,630 participants for meta-analysis. Random-effects model was used for the analysis, and heterogeneity analysis and publication bias test were conducted. Results The rate of universal HAIs was 0.14 percent. The rate of HAIs is increasing by 0.06 percent annually. The highest rate of HAIs was in the AFR, while the lowest prevalence were in AMR and WPR. Besides, AFR prevalence in central Africa is higher than in other parts of the world by 0.27 (95% CI, 0.22–0.34). Besides, E. coli infected patients more than other micro-organisms such as Coagulase-negative staphylococci, Staphylococcus spp. and Pseudomonas aeruginosa. In hospital wards, Transplant, and Neonatal wards and ICU had the highest rates. The prevalence of HAIs was higher in men than in women. Conclusion We identified several essential details about the rate of HAIs in various parts of the world. The HAIs rate and the most common micro-organism were different in various contexts. However, several essential gaps were also identified. The study findings can help hospital managers and health policy makers identify the reason for HAIs and apply effective control programs to implement different plans to reduce the HAIs rate and the financial costs of such infections and save resources.

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“…In this study, a significant increase was found in the SBSI rates for both types of infections between 2014 and 2019. Considering the surveillance data since 2007, there has been a significant decrease in invasive device-associated infections in ICUs throughout the country, and this increasing trend in SBSIs is striking [ 8 ].…”

Section: Discussionmentioning

confidence: 99%

ESBL production and carbapenem resistance increased the secondary bloodstream infection rates in intensive care units in Turkey, 2014–2019

Hekimoglu,

Yildiz,

Sahan

et al. 2022

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Aim: Secondary bloodstream infections (SBSIs) are caused by another infection and differ from primary bloodstream infections (PBSIs) in terms of prevention and treatment strategies. The aim of this study was to determine the risk factors for bloodstream infections which were secondary to the most common healthcare-associated infections caused by the most common microorganisms in intensive care units (ICUs) and to examine whether extended-spectrum beta lactamase (ESBL) production and carbapenem resistance is related to the higher risk or not. Methods: The study population consisted of patients in ICUs with ventilator-associated pneumonia (VAP), ventilator-associated event (VAE) or catheter-associated urinary tract infection (CAUTI) caused by E. coli, K. pneumoniae, P. aeruginosa or A. baumannii between 2014 and 2019. The data were obtained through the National Healthcare-associated Infections Surveillance Network. Multivariate logistic regression analysis was performed separately for VAP/VAE and CAUTI to determine the risk factors for the development of SBSI. Results: Microorganism, ICU type, bed capasity and carbapenem resistance were found to be risk factors for SBSI for both types of infection. For VAPs/VAEs, female gender and hospital type were also identified as risk factors. The highest risk was in K.pneumoniae and in emergency ICUs. Among the hospitals, the highest risk in VAPs/VAEs was found in government education and research hospitals. ESBL production for K . pneumoniae and E. coli increased the risk in patients with VAP/VAE; however, it did not increase in patients with CAUTI. Discussion: By using the risk factors, it may be possible to recognize SBSIs earlier, especially in patients with CAUTIs or VAPs/VAEs caused by carbapenem-resistant or ESBL-producing K. pneumoniae .

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National Infection Control Program in Turkey: The healthcare associated infection rate experiences over 10 years

Cited by 14 publications

References 24 publications

A 5-year surveillance of healthcare-associated infections in a university hospital: A retrospective analysis

A 5-year surveillance of healthcare-associated infections in a university hospital: A retrospective analysis

Global prevalence of nosocomial infection: A systematic review and meta-analysis

ESBL production and carbapenem resistance increased the secondary bloodstream infection rates in intensive care units in Turkey, 2014–2019

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