Evaluation of Hospital Infections in Intensive Care Unit/Yogun Bakim Unitesinde Gelisen Hastane Infeksiyonlarinin Degerlendirilmesi

Objective: The aim of this study is to detect nosocomial infectious agents and their resistance patterns in intensive care unit (ICU) of our hospital and to make a contribution to rational antibiotic usage in the light of these findings. Methods: 500 patients followed in our ICU between 2015 and 2016 were enrolled in this study. Infectious agents isolated from patients were identified with conventional methods and VITEK[R] 2 Compact (bioMerieux, Marcy l'Etoile, France) automated system. Results: In 87 of 500 patients, 105 episodes of nosocomial infections have been identified. Nosocomial infection rate was calculated as 21%. While bloodstream infections (42.8%) were most common in all nosocomial infections, ventilator-associated pneumonia took the first place among device-associated nosocomial infections. 127 microorganisms were detected in patients with diagnosis of nosocomial infections comprising 75 (59%) Gramnegative bacteria, 41 (32.75%) Gram-positive bacteria and 11 (8.66%) yeasts. The most common agents were Acinetobacter spp. (29.9%) and Pseudomonas aeruginosa (19.69%) in Gramnegative bacteria, and Enterococcus spp. (17.32%) and coagulasenegative staphylococci (CoNS) (13.38%) in Gram-positive bacteria. While the most common agents were Acinetobacter spp. (55.5%) in ventilator-associated pneumonia, and Candida spp. (33.3%) and P aeruginosa (29.6%) in urinary catheter-associated urinary tract infection, Enterococcus gallinarum (31.25%) was observed most commonly in central venous catheter-related bloodstream infections. 17 of 22 enterococcal strains were isolated from blood and 5 were obtained from urine. Resistance to vancomycin and teicoplanin were detected in two urinary E. faecium isolates. Methicillin resistance was identified as 47% in CoNS. Extended-spectrum p-lactamase positivity was determined in 40% of Escherichia coli strains and 60% of Klebsiella pneumoniae. Carbapenem resistance was observed in 40% of R aeruginosa, 20% of E. coli and 48.65% of A. baumanniistrains. According to the sensitivity results, the most effective antibiotics for Gram-negative bacteria were colistin and aminoglycosides against Acinetobacter spp. and Pseudomonas spp., and carbapenems against E. coli and Klebsiella strains. Conclusions: Monitoring of nosocomial infections, infectious agents and resistance rates in the ICU has great importance for prevention of infections and rational antibiotic use. Klimik Dergisi 2017; 30(3): 108-13. Key Words: Nosocomial infection,