Observational study of healthcare associated infections and mortality caused by carbapenem resistant Gram-negative bacteria in a Greek ICU

Healthcare associated infections (HCAIs) are a growing problem worldwide and contribute significantly to morbidity and mortality. The aim of this study was to assess the incidence and associated costs of HCAIs caused by carbapenem resistant (CR) Gram-negative bacteria at a single hospital and to evaluate predictors of mortality in this group of patients. In this prospective cohort study, all adult patients hospitalized for more than 48 hours in two intensive care units at a general hospital, during a six-month period, were recruited. All patients were assessed clinically by severity scores (APACHE II and SOFA) on admission and daily thereafter during hospitalization. Patients' blood and urine culture findings were examined daily. Costs were calculated by considering current costs of hospitalization in euro. The overall incidence of healthcare-associated infections was estimated at 40.8 per 1000 days of hospitalization. Ventilator associated pneumonia (VAP), and bloodstream infection (BSI) by carbapenem resistant Gram-negative pathogens were observed in 57.1%, and 28.6% of cases, respectively. The incidence of VAP, BSI and UTI was calculated at 22.8/1000 days of mechanical ventilation and at 9.6/1000 patient- days. Cost per case of VAP was calculated at 35610,37 euro and per case of BSI at 16095 euro. It is concluded that among healthcare associated infections caused by CR Gram-negative bacteria, VAP and BSI, were identified among a great proportion of adult patients hospitalized in the ICU. References