Device-associated, device-day infection rates in an Israeli adult general intensive care unit

• Published in: The Journal of hospital infection Vol. 44; no. 3; pp. 200 - 205
• Main Authors: Finkelstein, R., Rabino, G., Kassis, I., Mahamid, I.
• Format: Journal Article
• Language: English
• Published: Kent Elsevier Ltd 01-03-2000; Elsevier
• Subjects: Adult; Biological and medical sciences; bloodstream infections; Catheterization, Central Venous - adverse effects; Catheterization, Central Venous - instrumentation; Catheterization, Central Venous - utilization; Catheters, Indwelling - adverse effects; Catheters, Indwelling - utilization; Cross Infection - etiology; Cross Infection - microbiology; Cross Infection - prevention & control; Drug Resistance, Microbial; Equipment Contamination - prevention & control; Equipment Contamination - statistics & numerical data; General aspects; Humans; Infection Control - methods; intensive care unit; Intensive Care Units - classification; Intensive Care Units - statistics & numerical data; Israel; Medical sciences; Microbial Sensitivity Tests; Planification. Prevention (methods). Intervention. Evaluation; Pneumonia - etiology; Pneumonia - microbiology; Pneumonia - prevention & control; Prospective Studies; Public health. Hygiene; Public health. Hygiene-occupational medicine; Respiration, Artificial - adverse effects; Respiration, Artificial - instrumentation; Respiration, Artificial - utilization; Risk Factors; Sepsis - etiology; Sepsis - microbiology; Sepsis - prevention & control; Surveillance, nosocomial infections; Time Factors; Urinary Catheterization - adverse effects; Urinary Catheterization - instrumentation; Urinary Catheterization - utilization; urinary tract infection; Urinary Tract Infections - etiology; Urinary Tract Infections - microbiology; Urinary Tract Infections - prevention & control; ventilator-associated pneumonia; Asia; Israel; bloodstream infections; Surveillance, nosocomial infections; ventilator-associated pneumonia; intensive care unit; urinary tract infection; Human; Performance evaluation; Nosocomial infection; Sanitary program; Rate; Check; Care; Intensive care unit; Infection; Efficiency; Quality; Adult; Hospital; Sanitary surveillance; Public health
• ISSN: 0195-6701; 1532-2939
• DOI: 10.1053/jhin.1999.0682

Surveillance is an essential element of hospital infection control programs. Previous studies have shown that interhospital comparison of intensive care unit (ICU) nosocomial infections (NI) may be best made by comparing ICU-type-specific, device-associated infection rates and that these adjusted rates vary by ICU type. The aim of this study was to evaluate whether significant structural improvements introduced in an adult general ICU were associated with changes in the NI rates in this unit. In addition, we compared these rates with those of ICUs reported by the National Nosocomial Infections Surveillance (NNIS) System of the Centers for Diseases Control and Prevention. During a 12-month period 337 patients were surveyed. There were 20 ventilator-associated pneumonias (VAP)/1000 ventilator (VEN)-days, 12 bloodstream infections (BSI)/1000 central vascular catheter (CVC)-days and 14 urinary tract infection (UTI)/1000 indwelling urinary catheter (IUC)-days. Structural changes and reduction in device utilization ratios were not followed by change in NI rates in this unit. VAP and BSI rates were comparable to those reported for neurosurgical and burn ICUs, respectively, in the NNIS System, despite a much higher device utilization ratios. The present study provides specific surveillance data for further interhospital comparison with similar types of ICUs.