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Sunday, March 21, 2010
Grand Hall (Hyatt Regency Atlanta)
Background: HAIs increase morbidity and mortality. The frequency of HAIs in NSICUs is believed to significant as neurosurgical patients have an increased number of co-morbidities that increase the risk of HAIs and they often have prolonged unit stays.
Objective: To describe HAIs at a tertiary care center NSICU.
Methods: Observational retrospective study of HAIs in a NSICU from June 2008 to June 2009. HAIs were captured by active surveillance using NHSN definitions. The information was coded and captured for analysis in Excel and descriptive statistics were performed using SPSS v.15.
Results: During the study period 103 patients developed HAIs. Mean±SD age was 51.81±17.85 years. 661.2% patients were male and 36.9% were female. Race/ethnicity was: White 55%, hispanic 18.4%, and african american 17.5%. The majority of the patients (68.9%) had no pre-existing comorbidities and 24.3% had diabetes. HAIs were distributed as follows: Urinary tract infections 42.7%, catheter-related bloodstream infections 20.4%, ventilator-associated pneumonia 16.5%, deep surgical site infections 2.9%, and superficial surgical site infections 2.9%. Only 39.8% patients had fever and 71.5% had WBC counts >10K. The most common pathogens were: E. coli 19.4%, Enterococcus spp. 14.6%, K. pneumoniae 10.7%, S. aureus 10.7%, SSNA 10.7%, A. baumannii 6.8%, Enterobacter spp. 4.9%, Candida spp. 3.9%, MRSA 3.9%, and VRE 3.9%. 22.5% patients developed multiple infections.
Conclusions: Active surveillance using standardized definitions is a valuable tool for assessing the epidemiology of HAIs in the NSICU setting. NSICU HAIs are similar to those seen in other medical and surgical ICUs. In-depth analysis of HAIs in the NSICU will allow for the development of focused prevention and quality improvement activities.
Objective: To describe HAIs at a tertiary care center NSICU.
Methods: Observational retrospective study of HAIs in a NSICU from June 2008 to June 2009. HAIs were captured by active surveillance using NHSN definitions. The information was coded and captured for analysis in Excel and descriptive statistics were performed using SPSS v.15.
Results: During the study period 103 patients developed HAIs. Mean±SD age was 51.81±17.85 years. 661.2% patients were male and 36.9% were female. Race/ethnicity was: White 55%, hispanic 18.4%, and african american 17.5%. The majority of the patients (68.9%) had no pre-existing comorbidities and 24.3% had diabetes. HAIs were distributed as follows: Urinary tract infections 42.7%, catheter-related bloodstream infections 20.4%, ventilator-associated pneumonia 16.5%, deep surgical site infections 2.9%, and superficial surgical site infections 2.9%. Only 39.8% patients had fever and 71.5% had WBC counts >10K. The most common pathogens were: E. coli 19.4%, Enterococcus spp. 14.6%, K. pneumoniae 10.7%, S. aureus 10.7%, SSNA 10.7%, A. baumannii 6.8%, Enterobacter spp. 4.9%, Candida spp. 3.9%, MRSA 3.9%, and VRE 3.9%. 22.5% patients developed multiple infections.
Conclusions: Active surveillance using standardized definitions is a valuable tool for assessing the epidemiology of HAIs in the NSICU setting. NSICU HAIs are similar to those seen in other medical and surgical ICUs. In-depth analysis of HAIs in the NSICU will allow for the development of focused prevention and quality improvement activities.