Review article

DEVICE ASSOCIATED HEALTHCARE INFECTION AND SEPSIS IN INTENSIVE CARE UNIT

DUBRAVKA BARTOLEK HAMP orcid.org/0000-0001-8909-6747 ; Dubrovnik General Hospital, Dubrovnik, Croatia
GORDANA CAVRIĆ orcid.org/0000-0002-1499-5155 ; Merkur University Hospital, Zagreb, Croatia
INGRID PRKAČIN ; Merkur University Hospital, Zagreb, Croatia
KARLO HOURA ; Sv. Katarina Special Hospital, Zabok, Croatia
DARKO PEROVIĆ ; Sv. Katarina Special Hospital, Zabok, Croatia
TOMISLAV LJUBIČIĆ ; Dubrovnik General Hospital, Dubrovnik, Croatia
ANELA ELEZOVIĆ ; Split University Hospital Centre, Split, Croatia

Abstract

The incidence of healthcare-associated infections and sepsis (HAIs) is 5-10 times higher in patients in intensive care units (ICUs) than in those at other hospital departments. Predisposition for these lies in many intrinsic (disease severity, loss of immunity) and extrinsic factors (frequent use of broad-spectrum antibiotics with consequent presence of antibiotic-resistant pathogens). The majority of HAIs in ICUs are associated with the use of invasive devices (DA-HAIs; device-associated healthcare-associated infections) (19%). Their incidence differs among specifi c types of ICUs (2%-49%). The most frequent DA-HAI are central line-associated bloodstream infections (CLA-BSI), ventilator-associated pneumonia (VAP), catheter-associated urinary tract infection (CAUTI) and surgical site infections (SSI). SSI is most often described as a distinct and separate entity of HAIs in ICUs. Recently, gram-negative bacilli (Pseudomonas aeruginosa, Klebsiella pneumoniae and Acinetobacter spp.) are more frequently isolated in DA-HAIs than gram-positive ones (Staphylococcus aureus, Enterococcus spp.), often present as resistant strains. On the other hand, urinary or/and systemic infections tend to increase. DA-HAIs endanger and slow down patient recovery, prolong hospital stay, and generally increase the mortality rate. DA-HAIs are of special interest of the Hospital Committee Center for Infective Disease in order to improve patient safety and reduce total cost allocated for prevention of DA-HAIs. DA-HAI rate is the most useful intra- and inter-hospital measure to compare surveillance and effectiveness of preventive procedures among different ICU types.

Keywords

intensive care unit; nosocomial infection; ventilator-associated pneumonia; central line-associated blood stream infection; catheter-associated urinary tract infection

Hrčak ID:

151881

URI

https://hrcak.srce.hr/151881

Publication date:

27.1.2016.

Article data in other languages: croatian

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