Academic journal article Central European Journal of Public Health

Healthcare-Associated Infections at Intensive Care Unit of Department of Anesthesiology and Intensive Medicine at Martin Faculty Hospital

Academic journal article Central European Journal of Public Health

Healthcare-Associated Infections at Intensive Care Unit of Department of Anesthesiology and Intensive Medicine at Martin Faculty Hospital

Article excerpt

SUMMARY

We analyzed the occurrence of healthcare-associated infections (HAI) at intensive care unit of the Department of Anesthesiology and Intensive Medicine of Martin Faculty Hospital in 2008. We performed a retrospective-prospective observation according the protocol of European HELICS (Hospital in Europe Link for Infection Control and Surveillance) system. We found 11 HAI (4.45%) which on average prolonged the length of hospitalization by 6 days. The most frequent localisation of HAI was the respiratory tract. By our own observation we found the same number of HAI cases as it had been reported officially but the observed and reported cases do not match. The surveillance system HELICS uses definitions slightly different from those used in Slovakia. The severity of health status of a patient at admission influences the risk of HAI. We suggest a continuing collaboration on HELICS system with further involvement of all departments of Martin Faculty Hospital and creation of a hospital infection control team. We also suggest an improvement in testing for etologic agents of HAI and an introduction of methods of molecular epidemiology in diagnostics, as well as quantification of costs related to occurrence of HAI and to assess an implication of automated monitoring system in HAI surveillance.

Key words: infection, nosocomial, intensive care, healthcare-associated

INTRODUCTION

Healthcare-associated infections (HAI) have always accompanied the provision of healthcare. Long ago they seemed inevitable (1). Currently, HAI are a common cause of morbidity and mortality in hospitalized patients worldwide. They create an economic disbalance in making use of resources for the primary and secondary healthcare. They cut short finances from the already low healthcare budget due to causes that are preventable. The experts call for a more profound study of the matter (2, 3, 4).

Healthcare is offered to a population with increasing susceptibility to infections (ageing, immunodeficience) and severe underlying diseases (e.g. diabetes). The diagnostic and therapeutical procedures create a higher risk of infectious complications (intensive care, invasive interventions, transplantations, etc.). Therefore the importance of HAI is growing and healthcare systems invest more time and resources to solve this problem (5).

According to data from the Epidemiological Information System (EPIS) of the Slovak Republic, in past 10 years (1999-2008) the Department of Anesthesiology and Intensive Medicine (DAIM) reports the highest occurrence of HAI (3.01 %) in Martin Faculty Hospital (MFH). There were 71 cases of HAI in 2,362 patients hospitalized at this department. However, in scientific literature the occurrence at similar departments is usually higher. Podstatová (6) says that the assessed incidence in hospitals is 5-10% and at departments of ICU type it may be even 20%. That is why we decided to perform our study at DAIM.

MATERIAL

We observed all patients hospitalized at DAIM in 2008, who stayed at the department for 2 or more days.

METHODS

We did a retrospective-prospective observation of HAI occurrence at the DAIM according the protocol "Surveillance of Nosocomial Infections in Intensive Care Units" (7) of the European HELICS system (Hospital in Europe Link for Infection Control and Surveillance). The HELICS system is a product of the IPSE (Improving Patient Safety in Europe) project executed in collaboration with the World Health Organisation (WHO), the European Society of Clinical Microbiology (ESCMID) and surveillance networks in European countries, funded by the European Commission Directorate General for Health and Consumer Protection (DG SANCO).

An infection is considered as acquired at ICU if it starts after 48 hours from admission to a ward. Only patients staying more than two calendar days enter the study because patients hospitalized less than 48 hours cannot acquire the HAI per definitionem. …

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