ISSN : 2146-3123
E-ISSN : 2146-3131

Impact of Education and Process Surveillance on Device-Associated Health Care-Associated Infection Rates in a Turkish ICU: Findings of the International Nosocomial Infection Control Consortium (INICC)
Ahmet Dilek 1, Fatma Ülger 1, Musa Acar 1, Şaban Esen 2, Hakan Leblebicioğlu 2, Victor D. Rosenthal 3
1Department of Anesthesiology and Reanimation, Faculty of Medicine, Ondokuz Mayıs University, Samsun, Turkey
2Department of Clinical Microbiology and Infectious Diseases, Faculty of Medicine, Ondokuz Mayıs University, Samsun, Turkey
3International Nosocomial Infection Control Consortium, Buenos Aires, Argentina
DOI : 10.5152/balkanmedj.2011.028
Pages : 88-92


Objective: The aim of this study was to analyze the impact of process and outcome surveillance on rates of device-associated health care-associated infections (DA-HAI) in an intensive care unit (ICU) in Turkey over a four-year period.

Material and Methods: An open label, prospective cohort, active DA-HAI surveillance study was conducted on 685 patients admitted to the ICU of a university hospital in Turkey from January 2004 to December 2007, implementing the methodology developed by the International Nosocomial Infection Control Consortium. DA-HAI rates were recorded according to Centers for Disease Control and Prevention (CDC), National Healthcare Safety Network (NHSN) definitions. We analyzed the rates of DA-HAI, mechanical ventilator-associated pneumonia (VAP), central line-associated bloodstream infection (CLA-BSI), and catheter-associated urinary tract infection (CAUTI), as well as microorganism profile, extra length of stay, and hand hygiene compliance. Pooled DA-HAI rates were calculated and compared by year.

Results: The DA-HAI rate per 100 patients declined as follows: for 2004, the DA-HAI rate was 58.4%; for 2005, it was 38.9%; for 2006, it was 34.8%; and for 2007, it was 10.9%. The DA-HAI rate per 1,000 bed-days also declined: for 2004, it was 42.8, and for 2007 it was 10.7. The rates decreased from 25.8 to 13.4 for VAP; from 29.9 to 25.0 for CLA-BSI; and from 9.2 to 6.2 for CAUTI cases per 1,000 device-days during the study period.

Conclusion: Process and outcome surveillance of DA-HAI significantly reduced DA-HAI.

Keywords : Health care-associated infection, ventilator-associated pneumonia, central line-associated bloodstream infection, catheter-associated urinary tract infection, outcome and process surveillance, hand hygiene, intensive care unit

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