Device-associated nosocomial infection surveillance in the neurosurgery intensive care unit of the Inonu University Turgut Ozal Medical Center

Patients in the intensive care units (ICUs) have a high risk of infection due to the severity of illness of the patients treated and the high number of medical devices used. For patients requiring neurosurgical intensive care there are certain risk factors (e.g. altered consciousness, impaired protective reflexes, head injury) of acquiring nosocomial infections (NIs). In this study, we prospectively investigated NIs, device utilization ratios and device-associated infection rates, isolated agents and their antimicrobial susceptibilities in the neurosurgery intensive care unit of the Inonu University Turgut Ozal Medical Center between May 2006-April 2007. 613 patients with a total of 3561 patient days were enrolled. The overall incidence of NIs was 13.9% per 100 patients and the incidence density 23.8 per 1,000 patient days. Pneumonia (65.8%), bloodstream infections (16.5%), and urinary tract infections (15.3%) were the most frequent NIs recorded. The rate of ventilator-associated pneumonia was 67.2 infections per 1,000 ventilator-days, the rate of catheter-associated bloodstream infection was 8.1 per 1,000 central line-days, and the rate of catheter-associated urinary tract infection was 3.9 infections per 1,000 urinary catheter-days. Of the bacteria determined 56.8% were Gram-negative. In this group Pseudomonas aeruginosa was the most frequently isolated (25%). Staphylococcus aureus (20.4%) was the most frequently found Gram-positive bacteria (38.6%). We aim to investigate the causes of ventilator-associated pneumonia and catheter-associated bloodstream infections and to determine necessary preventive measures in an observative and multidisciplinary studies.