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Inventi Impact: Pathology

Articles

  • Inventi:hmd/38/13
    SURVEILLANCE ON SECULAR TRENDS OF INCIDENCE AND MORTALITY FOR DEVICEâ??ASSOCIATED INFECTION IN THE INTENSIVE CARE UNIT SETTING AT A TERTIARY MEDICAL CENTER IN TAIWAN, 2000â??2008: A RETROSPECTIVE OBSERVATIONAL STUDY
    31-Dec-2012 Research 2013 : January - March
    Yin-Yin Chen, Liang-Yu Chen, Seng-Yi Lin, Pesus Chou, Shu-Yuan Liao, Fu-Der Wang

    Background: Deviceââ?¬â??associated infection (DAI) plays an important part in nosocomial infection. Active surveillance\r\nand infection control are needed to disclose the specific situation in each hospital and to cope with this problem\r\neffectively. We examined the rates of DAI by antimicrobial-resistant pathogens, and 30ââ?¬â??day and inââ?¬â??hospital\r\nmortality in the intensive care unit (ICU).\r\nMethods: Prospective surveillance was conducted in a mixed medical and surgical ICU at a major teaching hospital\r\nfrom 2000 through 2008. Trend analysis was performed and logistic regression was used to assess prognostic\r\nfactors of mortality.\r\nResults: The overall rate of DAIs was 3.03 episodes per 1000 deviceââ?¬â??days. The most common DAI type was\r\ncatheterââ?¬â??associated urinary tract infection (3.76 per 1000 urinary catheterââ?¬â??days). There was a decrease in DAI rates\r\nin 2005 and rates of ventilatorââ?¬â??associated pneumonia (VAP, 3.18 per 1000 ventilatorââ?¬â??days) have remained low since\r\nthen (p < 0.001). The crude rates of 30ââ?¬â??day (33.6%) and inââ?¬â??hospital (52.3%) mortality, as well as infection by\r\nantibiotic-resistant VAP pathogens also decreased. The most common antimicrobial-resistant pathogens were\r\nmethicillinââ?¬â??resistant Staphylococcus aureus (94.9%) and imipenemââ?¬â??resistant Acinetobacter baumannii (p < 0.001),\r\nwhich also increased at the most rapid rate. The rate of antimicrobial resistance among Enterobacteriaceae also\r\nincreased significantly (p < 0.05). After controlling for potentially confounding factors, the DAI was an independent\r\nprognostic factor for both 30ââ?¬â??day mortality (OR 2.51, 95% confidence interval [CI] 1.99ââ?¬â??3.17, p = 0.001) and\r\ninââ?¬â??hospital mortality (OR 3.61, 95% CI 2.10ââ?¬â??3.25, p < 0.001).\r\nConclusions: The decrease in the rate of DAI and infection by resistant bacteria on the impact of severe acute\r\nrespiratory syndrome can be attributed to active infection control and improved adherence after 20.

    How to Cite this Article
    CC Compliant Citation: Chen et al.: Surveillance on secular trends of incidence and mortality for device -associated infection in the\r\nintensive care unit setting at a tertiary medical center in Taiwan, 2000 -2008: A retrospective observational study. BMC Infectious\r\nDiseases 2012 12:209, doi:10.1186/1471-2334-12-209.
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