The national rate of intensive care units-acquired infections, one-year retrospective study in Iran

Abstract

Background Hospital-acquired infections (HAIs) in intensive care units (ICUs) are among the avoidable morbidity and mortality causes. This study aimed at investigating the rate of ICU-acquired infections (ICU-AIs) in Iran. Methods For the purpose of this multi-center study, the rate of ICU-AIs calculated based on the data collected through Iranian nosocomial infections surveillance system and hospital information system. The data expanded based on 12 months of the year (13,632 records in terms of “hospital-ward-month”), and then, the last observation carried forward method was used to replace the missing data. Results The mean (standard deviation) age of 52,276 patients with HAIs in the ICUs was 47.37 (30.78) years. The overall rate of ICU-AIs was 96.61 per 1000 patients and 16.82 per 1000 patient-days in Iran’s hospitals. The three main HAIs in the general ICUs were ventilator-associated events (VAE), urinary tract infection (UTI), and pneumonia events & lower respiratory tract infection (PNEU & LRI) infections. The three main HAIs in the internal and surgical ICUs were VAE, UTI, and bloodstream infections/surgical site infections (BSI/SSI). The most prevalent HAIs were BSI, PNEU & LRI and eye, ear, nose, throat, or mouth (EENT) infections in the neonatal ICU and PNEU & LRI, VAE, and BSI in the PICU. Device, catheter, and ventilator-associated infections accounted for 60.96, 18.56, and 39.83% of ICU-AIs, respectively. The ventilator-associated infection rate was 26.29 per 1000 ventilator-days. Based on the Pabon Lasso model, the lowest rates of ICU-AIs (66.95 per 1000 patients and 15.19 patient-days) observed in zone III, the efficient area. Conclusions HAIs are common in the internal ICU wards. In fact, VAE and ventilator-related infections are more prevalent in Iran. HAIs in the ICUs leads to an increased risk of ICU-related mortality. Therefore, to reduce ICU-AIs, the specific and trained personnel must be responsible for the use of the devices (catheter use and ventilators), avoid over use of catheterization when possible, and remove catheters earlier.

Increased Involvement of Klebsiellapneumoniae and Enterococcusfaecium in Healthcare-Associated Infections of Intensive Care Units in Taiwan

“…The HAIs in Taiwan have a lower incidence density than those in Iran. In addition, the values for the MICU and general ICU in Taiwan are higher than those in Iran [14]. The most common HAIs of…”

“…BSIs rather than UTIs were the HAIs with the highest frequency in Taiwan, in contrast to the pattern in the USA. In Iranian ICUs, the incidence of BSIs, UTIs, and HAP has been reported to be 2.21, 3.32, and 2.55, respectively, every 1000 person-days [14]. The incidence densities of BSIs, UTIs, and HAP in the ICUs of Taiwan were 2.1, 1.9, and 0.6, respectively, every 1000 person-days.…”

Identification and antifungal susceptibility profile of filamentous fungi isolated from cases of healthcare associated infections

“…In ICU, although bacteria are important of infections, fungal infections represent as a grave problem and are associated with high morbidity and mortality rates, increased hospital stay and high health care cost. 7 Although vast majority of these infections are caused by C. albicans and A. fumigatus, in recent years new opportunists including yeast-like and filamentous fungi has emerged as an important cause of ICU-acquired invasive fungal infections. 8 In the present study, 42% of invasive fungal infections (IFI) were due to Candida spp.…”

The Standardization of Hospital-Acquired Infection Rates Using Prediction Models in Iran: Observational Study of National Nosocomial Infection Registry Data

“…With the help of these systems and their linkage, we have access to data on the observed number of HAIs in different hospitals during the year of the study. More details about the data source, linkage of the data source, and national standard for hospital performance indicators (ie, average length of stay [LOS], bed occupancy rate [BOR], bed turnover [BTO] rate, death-to-bedridden ratio, and Pabon Lasso model) are available elsewhere [ 12 , 13 ].…”