Evaluation of Nosocomial Infections in Neurology-Neurosurgery Intensive Care Unit

Introduction: Intensive care unit (ICU)-acquired infections increase morbidity, mortality and treatment cost. In this study, we aim to evaluate epidemiological features of ICU-acquired infections in patients followed in neurology-neurosurgery ICU. Patients and Methods: The study was conducted in Ankara Training and Research Hospital between 1 July 2005 and 31 December 2006. The patients hospitalized in neurology-neurosurgery ICU more than 48 hours were followed prospectively. The data were collected from patients’ cards and forms used by infection control committee for surveillance purposes. Centers for Disease Control and Prevention (CDC) definitions were used for diagnosis of nosocomial infections. Results: In the 18 months period, 1066 patients followed in the neurology-neurosurgery ICU were included in the study. Three hundred and twenty five ICU-acquired infections were detected in 206 (19.3%) patients in 5564 patient days. Infection rate was 30.5 per 100 patients and 58.4 per 1000 patient days. The most frequent site-specific infection was urinary-tract infection (44.3%). This was followed by primary blood stream infection (22.1%) and lower respiratory tract infection (20.6%). Incidence densities of device-associated infections per 1000 device-days were as follows: 26.48 central-line associated blood-stream infections, 18.26 urinary-catheter associated urinary tract infections and 40.14 ventilator-associated pneumonias. Three hundred and fifty seven microorganisms were isolated in 325 ICU-acquired infections. The most frequent microorganisms responsible for ICU-acquired infections were Escherichia coli (16.2%), Acinetobacter spp. (20.4%) and Enterococcus spp. (18.5%). Methicillin resistance rate of Staphylococcus aureus was (20/30) 66.7%. Penicillin resistance rate of Enterococcus spp. was 33.8%. Gram-negative enteric pathogens were found to have extendedspectrum beta-lactamases at a rate of 29%. Conclusion: The distribution of the site-spesific infections, responsible microorganisms and antimicrobial susceptibility may be different for each ICU. Infection control precautions can be planned and appropriate ampiric therapy can be administered according to these data.