العدوى المكتسبة في وحدات العناية المركزة في مستشفيات محافظة البصرة ،العراق 2013 == Nosocomial Infection in Intensive Care Units at Basra Hospitals, Iraq, 2013
Author name:
زكي عبد السادة صغیر
Supervisor name:
ايمان عدنان القصير
General topic:
Medicine
Specific topic:
Applied Epidemiology
Degree:
Higher Diploma
University:
University of Baghdad - Faculty Of Medicine
Language:
English
University location:
Baghdad
First pages:
19T1608 - p.pdf
Abstract:
Nosocomial infection is defined as infection not present and withoutevidence of incubation at the time of admission to health care setting. It isconsidered as a major public health problem worldwide, which is affectedboth developed and developing countries. It was contributed to highmorbidity and mortality, and will become even more important as a publichealth problem with increase economic and human impact. The patients inICUs are 5 - 10 time more likely to have NCI than other hospital patients. Thefrequency of NCI at different anatomical sites and the risk of infection varyby the type of ICU, while the frequency of specific pathogens varies byinfection sites.In Iraq, there was no accurate proportion and enforced surveillance of the NCIin the MOH, and few academic studies that dealt with this topic.The objectiveof this study, to determine the burden of NCI and distribution by anatomicalsites in the ICUs. We conveniently select (110) patients admitted to the ICUsof three major hospitals in Basra city from 15th May to 1st of August, 2013.A total number of 32( 29.1%) patients developed at least one nosocomialinfection. The urinary tract infection was the most frequent ICUs nosocomialinfection 39.6%, followed by Bloodstream infection 25%, Lower respireterytract infection 22.9% and lastly surgical site infection 12.5%. There are acertain specific risk factors play important role in occurrence of NCI in ICUssuch as use of the invasive devices, including endotracheal, tracheostomy,nasogastric intubation and urinary catheterization, which is consideredstatically significant association with NCI in the ICUs ( P< 0.05) also antherpositive correlation( r = 0.7) between rates of NCI and length of ICU stay hasbeen reported and high coverage of antibiotic as prophylaxis raise ofantibiotic - resistance NCI in the ICUs which considered as a risk factor, nosignificant association with NCI (P> 0.05). In spite of heavy use of antibioticVIIin the ICUs, we found heavy growth microorganisms in Urine, Blood, andsputum and swap cultures. Gram negative bacteria cause (83.3%) of infection,which is the most common cause of NCI in the ICUs, followed by Grampositive bacteria (9.8%) and fungus (5.9%). These pathogens are ubiquitousin health care sitting. The Kliebsiella ssp was the most common, followed byE.coli organism. It was concluded at intensive care units of the majorhospitals in Basra city had higher rate of the NCI, more than that in developedcountries and most of developing countries. The nosocomial urinary tractinfection was the most common NCI sites in ICUs, followed by blood streaminfection. Enhance surveillance system and Enforced implementation of ICCguidelines in ICUs should be emphasize.
