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Surveillance, control and management of infections in intensive care units in Southern Europe, Turkey and Iran – A prospective multicenter point prevalence study

2013; Elsevier BV; Volume: 68; Issue: 2 Linguagem: Inglês

10.1016/j.jinf.2013.11.001

1532-2742

Hakan Erdem, Asuman İnan, Selma Altındiş, Biljana Carević, Mehrdad Askarian, Lucy E. Cottle, Bojana Beović, Ákos Csomós, Krassimir Metodiev, Sead Ahmetagić, Arjan Harxhi, Lul Raka, Krsto Grozdanovski, M Nechifor, Emine Alp, Fatma Bozkurt, Salih Hoşoğlu, İsmail Balık, Gülden Yılmaz, Matjaž Jereb, Fatemeh Moradi, NIKOLAY PETROV, Selçuk Kaya, İftihar Köksal, Turan Aslan, Nazif Elaldı, Yasemin Akkoyunlu, Seyyed Alireza Moravveji, Gábor Csató, Balazs Szedlak, Filiz Akata, Serkan Öncü, Svjetlana Grgić, Gorana Ćosić, Chavdar Stefanov, Mehrdad Farrokhnia, Mária Müller, Cătălina Luca, Nada Koluder, Volkan Korten, Viliyan Platikanov, Petja Ivanova, Soheil Soltanipour, Mahmood Vakili, Saman Farahangiz, Abdorrahim Afkhamzadeh, Nicholas J. Beeching, Salman Shaheer Ahmed, A Cami, Ramin Shiraly, Anja Jazbec, Tomislav Mirković, Hakan Leblebicioğlu, Kurt G. Naber,

Nosocomial Infections in ICU

Summary Objective We aimed to compare the features of intensive care units (ICUs), their antimicrobial resistance patterns, infection control policies, and distribution of infectious diseases from central Europe to Mid-West Asia. Methods A cross-sectional point prevalence study was performed in 88 ICUs from 12 countries. Characteristics of ICUs, patient and antibiotic therapy data were collected with a standard form by infectious diseases specialists. Results Out of 749, 305 patients at least with one infectious disease were assessed and 254 patients were reported to have coexistent medical problems. When primary infectious diseases diagnoses of the patients were evaluated, 69 had community-acquired, 61 had healthcare-associated, and 176 had hospital-acquired infections. Pneumonia was the most frequent ICU infection seen in half of the patients. Distribution of frequent pathogens was as follows: Enteric Gram-negatives ( n = 62, 28.8%), Acinetobacter spp. ( n = 47, 21.9%), Pseudomonas aeruginosa ( n = 29, 13.5%). Multidrug resistance profiles of the infecting microorganisms seem to have a uniform pattern throughout Southern Europe and Turkey. On the other hand, active and device-associated infection surveillance was performed in Turkey more than Iran and Southeastern Europe ( p < 0.05). However, designing antibiotic treatment according to culture results was highest in Southeastern Europe ( p < 0.05). The most frequently used antibiotics were carbapenems ( n = 92, 30.2%), followed by anti-gram positive agents (vancomycin, teicoplanin, linezolid, daptomycin, and tigecycline; n = 79, 25.9%), beta-lactam/beta lactamase inhibitors ( n = 78, 25.6%), and extended-spectrum cephalosporins ( n = 73, 23.9%). Conclusion ICU features appears to have similar characteristics from the infectious diseases perspective, although variability seems to exist in this large geographical area.