Prevalence of nosocomial infections at intensive care units in Turkey: A multicentre 1-day point prevalence study

In order to determine the prevalence of intensive care unit (ICU)-acquired infection at ICUs in Turkey and to identify associated risk factors, predominant infecting organisms and mortality rates, a 1-d point prevalence study was carried out on 19 September 2001. A total of 56 ICUs from 22 university and teaching hospitals participated and a total of 236 completed case report forms were accepted for analyses. A total of 115 patients (48.7%) had 1 or more ICU-related nosocomial infections on the study d. Pneumonia and lower respiratory tract infection (28.0%), laboratory confirmed blood stream infection (23.3%) and urinary tract infection (15.7%) were the most frequent types. Endotracheal tube, urinary catheter, multi-trauma on admission, stress ulcer prophylaxis, nasogastric feeding and mechanical ventilation were risk factors. The most frequently reported isolates were Pseudomonas aeruginosa (20.8%), Staphylococcus aureus (18.2%), Acinetobacter spp. ( 18.2%) and Klebsiella spp. (16.1%). Of the patients, 72.9% were receiving antimicrobials on the study d for treatment or prophylaxis. Most frequently administered antimicrobials were aminoglycosides (37.2%), carbapenems (31.4%), glycopeptides ( 23.3%), cephalosporins (18.0%) and antifungals (5.8%). According to a 4-week follow-up, 70 (29.7%) patients died, 22 (9.3%) of whom died from ICU related infections. In conclusion this study showed that ICU related infections are common and often associated with resistant microorganisms. The results provide epidemiological information that will help to implement infection control policies in ICUs.