Comparative Epidemiology of Device-Associated Infections in an Adult ICU at a Tertiary Care Center

Background: Hospital-acquired infections (HAIs), particularly device-associated infections (DAIs) in ICUs, pose a significant global health burden, especially in low- and middle-income countries.Objectives: This study aims to estimate the HAI burden by analyzing DAI rates and resistance patterns in ICU settings, contributing to evidence-based infection control strategies.Methods: We conducted a six-month prospective observational study in the adult ICU of GTBH (July–December ۲۰۲۴), focusing on patients with DAIs. Incidence and device utilization rates were calculated using CDC-standardized metrics based on device and patient days.Results: Out of ۲۸۶ patients, ۴۰ developed a total of ۶۲ DAIs, comprising ۲۵ cases of ventilator-associated pneumonia (VAP) (۴۰.۳%), ۱۹ cases of catheter-related bloodstream infections (CLABSI) (۳۰.۶۵%), and ۱۸ cases of catheter-associated urinary tract infections (CAUTI) (۲۹.۰۳%). VAP had the highest cumulative infection rate (۲۲.۶%), followed by CLABSI (۲۱%) and CAUTI (۱۰.۸%). Acinetobacter baumannii was the dominant isolate in VAP cases, Klebsiella pneumoniae and Enterobacter spp. were predominant in CLABSI cases, and non-albicans Candida was the leading pathogen in CAUTI cases. Significant antimicrobial resistance was observed, especially among Acinetobacter and Pseudomonas species. Notably, the case fatality rate among DAI patients reached ۵۷.۵%.Conclusion: In conclusion, our surveillance study highlights a substantial burden of DAIs in the ICU, with VAP being the most prevalent. The dominance of multidrug-resistant pathogens and the striking ۵۷.۵% fatality rate emphasize the urgent need for robust infection control, tailored stewardship programs, and continuous local epidemiological monitoring.

کلیدواژه ها:

Intensive Care Unit ، Device-Associated Infections ، Surveillance ، Epidemiology ، Infection Control