GKDA Derg, 2(18), p. 46-51
Objective: In this study the aim was to determine the types of nosocomial infections developed, their causative pathogens, and antibacterial resistance profiles of these pathogens in intensive care unit. Material and Methods: We studied 189 patients who were treated more than 72 hours in our intensive care unit (ICU). Sputum, tracheal aspirate, urine sample, swabs from any wound and blood sample in patients with a fever higher than 38°C were collected to evaluate the infectious status during the patients first admission into the intensive care unit. The previously prescribed antibiotic regimen has been continued till the culture results obtained. The patients were followed up prospectively daily together with infectious disease specialists. Nosocomial infections were defined based on CDC (Centers for Disease Control and Prevention) criteria. Results: Totally, there were 42 patients who developed 77 infectious episodes. The types of infections were as follows: ventilation-associated pneumonia (VAP) (n=37, 45.5%), urinary tract infections (n=23, 29.9%), pneumonia (n=18, 23.4%), primary bacteremia (n=2, 2.6%). The most frequent pathogens were Acinetobacter spp. (27.3%), Pseudomonas aeruginosa (19.5%), Stafilococcus aureus (18.2%), E.coli (16.9%), Candida spp. (16.9%), Enterococcus spp. (11.7%). Resistance to methicillin was 71.4% among S.aureus isolates, without any resistance to vancomycin. The most frequent pathogens in pneumonia patients were determined to be P. aeruginosa (27.8%) and methicillin resistance S.aureus (MRSA) (22.2%). The most frequent pathogens in VAP patients were Acinetobacter spp. (48.6%) and P.aeruginosa (20.0%), in urinary tract infections; Esherichia coli (40.9%) and Enterococcus spp. (40.9%). MRSA was determined in both primary bacteremia patients. Conclusion: Monitoring of nosocomial infections, infectious agents and resistance rules should be evaluated together. Surveillance studies should be performed regularly, in addition to application of effective infection control policies so that the prevention of infections in ICU can be effectively controlled.