Evaluation of Nosocomial Infections.and Antibiotic Resistance Profiles in the Anesthesiology Intensive Care Unit

Abstract

Objective: We aimed to determine the etiological agents of nosocomial infections and susceptibility patterns in our intensive care unit (ICU). Materials and methods: The study included 341 patients (mean age 47.8-122.7 years) who were admitted to our ICU longer than 72 hours between May 2007 and July 2008. All the patients were followed-up daily together with infectious disease specialists. Nosocomial infections were defined according to the CDC criteria (Centers for Disease Control and Prevention). Blood cultures and cultures from infectious foci were taken from patients who were thought to have a nosocomial infection. Results: A total of 141 episodes of nosocomial infection developed in 57 patients (16.7%), including ventilator-associated pneumonia (74 episodes, 52.5%), primary bacteremia (n=49, 34.8%), urinary system infections (n=15, 10.6%), and surgical site infections (n=3, 2.1%). Isolated bacteria were as follows: S. aureus (22%), P. aeruginosa (15.6%), Acinetobacter spp. (14.2%), E. coli (14.2%), Klebsiella spp (11.4%), coagulase-negative staphylococcus (CNS) (7.8%), Enterococcus spp. (5%), Enterobacter spp. (4.3%), S. pneumoniae (2.8%), and S. maltophilia (2.1%). Resistance rates to oxacillin were 90.3% in S. aureus and 81.8% in CNS isolates. In Enterococcus spp., resistance to ampicillin was 71.4%, high-level aminoglycoside resistance was 85.7%, with no resistance to vancomycin. Extended-spectrum beta-lactamase-positive strains accounted for 70% for E. coil and 93.7% for Klebsiella species. Conclusion: Monitoring of nosocomial infections and infectious agents together with resistance rates in the ICU has great importance in both the prevention of infections and rational antibiotic use.