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905 Health Care Associated Infections in Ten Saudi Intensive Care Units: The Result of a One Year Incidence Study

Sunday, March 21, 2010
Grand Hall (Hyatt Regency Atlanta)
Muhammad Abdul rahman Halwani, PhD , Directorate of Health Affairs. Infection Control & Central Sterilization., Jeddah, Saudi Arabia
Nedal Abd al jaleel Tashkani, MD , Directorate of Health Affairs. Infection Control & Central Sterilization, Jeddah, Saudi Arabia
Abdal aziz Faisal Basuny, BSN , Directorate of Health Affairs. Infection Control & Central Sterilization, Jeddah, Saudi Arabia
Background:

Health Care Associated Infections (HCIs) is an increasing problem in most of the Adult Intensive Care Units (AICUs) in the Western Province of Saudi Arabia.

Objective:

To detect the incidence of HCIs in ten AICUs in the Western Province of Saudi Arabia and the distribution of pathogens involved in those infections and their resistance rates.

Methods: Prospective study and analysis of concurrent surveillance data. All patients admitted for at least 48 hours to those 10 specific ICUs from February 2007 to January 2008 using laboratory based ward surveillance.

Results:

A total number of 851 HCIs were detected in 5523 patients admitted and stayed for 53,025 patient days with a mean length of stay of 9 days. The incidence rate for HCI was 16 per 1000 patient days. Ventilator Associated Pneumonia (VAP) 51% was the most frequent site of infection detected followed by Catheter Related Urinary Tract Infection (CRUTI) 23%, Center Line Related Blood Stream Infection (CBSI) 20%, Surgical Site Infection (SSI) 4%, and Soft Skin Tissue Infections (SST) 2%. Device exposure gave an incidence of 12 per 1000 ventilator days in ventilator associated pneumonia, 11 CRUTIs per 1000 foly catheter days and 8 CBSIs per 1000 central venous catheter days. Pseudomonas aeruginosa was the most common isolated pathogen during the whole study period (18%) followed by Acintobacter baumanii, Escherichia coli (17%), Klebsiella pneumonia (13%) and MRSA (12%). More than 45 % of the Gram negative isolates were multidrug resistance.

Conclusions:

This is the first incidence study reported concerning this area of the Kingdom and the first bench marking results to be reported in the province. Comparison to other international published studies it might be applicable in crude figures only. The high isolation of Pseudomonas aeruginosa probably indicates the presence of an environmental reservoir that needs to be investigated. The high rate of resistance clarifies a poor compliance with antibiotic policy within the studied hospitals. Investigating the source of Pseudomonas aeruginosa is urgently required. Yearly follow-up studies are necessary for future comparison and detection of infection increase.