Skip to main content Accessibility help
×
Home

Incidence and Pathogen Distribution of Healthcare-Associated Infections in Pilot Hospitals in Egypt

  • Isaac See (a1) (a2), Fernanda C. Lessa (a1), Omar Abo ElAta (a3), Soad Hafez (a4), Karim Samy (a3), Amani El-Kholy (a5), Mervat Gaber El Anani (a5), Ghada Ismail (a6), Amr Kandeel (a7), Ramy Galal (a7), Katherine Ellingson (a1) and Maha Talaat (a3)...

Abstract

Objective.

To report type and rates of healthcare-associated infections (HAIs) as well as pathogen distribution and antimicrobial resistance patterns from a pilot HAI surveillance system in Egypt.

Methods.

Prospective surveillance was conducted from April 2011 through March 2012 in 46 intensive care units (ICUs) in Egypt. Definitions were adapted from the Centers for Disease Control and Prevention's National Healthcare Safety Network. Trained healthcare workers identified HAIs and recorded data on clinical symptoms and up to 4 pathogens. A convenience sample of clinical isolates was tested for antimicrobial resistance at a central reference laboratory. Multidrug resistance was defined by international consensus criteria.

Results.

ICUs from 11 hospitals collected 90,515 patient-days of surveillance data. Of 472 HAIs identified, 47% were pneumonia, 22% were bloodstream infections, and 15% were urinary tract infections; case fatality among HAI case patients was 43%. The highest rate of device-associated infections was reported for ventilator-associated pneumonia (pooled mean rate, 7.47 cases per 1,000 ventilator-days). The most common pathogens reported were Acinetobacter species (21.8%) and Klebsiella species (18.4%). All Acinetobacter isolates tested (31/31) were multidrug resistant, and 71% (17/24) of Klebsiella pneumoniae isolates were extended-spectrum β-lactamase producers.

Conclusions.

Infection control priorities in Egypt should include preventing pneumonia and preventing infections due to antimicrobial-resistant pathogens.

Copyright

Corresponding author

Centers for Disease Control and Prevention, 1600 Clifton Road NE, Mailstop A-24, Atlanta, GA 30333 (isee@cdc.gov)

References

Hide All
1.Klevens, RM, Edwards, JR, Richards, CL Jr, et al. Estimating health care-associated infections and deaths in U.S. hospitals, 2002. Public Health Rep 2007;122:160166.
2.Burton, DC, Edwards, JR, Horan, TC, Jernigan, JA, Fridkin, SK. Methicillin-resistant Staphylococcus aureus central line-associated bloodstream infections in US intensive care units, 19972007. JAMA 2009;301:727736.
3.Burton, DC, Edwards, JR, Srinivasan, A, Fridkin, SK, Gould, CV. Trends in catheter-associated urinary tract infections in adult intensive care units—United States, 1990-2007. Infect Control Hosp Epidemiol 2011;32:748756.
4.Allegranzi, B, Nejad, SB, Combescure, C, et al. Burden of endemic health-care-associated infection in developing countries: systematic review and meta-analysis. Lancet 2011;377:228241.
5.Haley, RW, Culver, DH, White, JW, et al. The efficacy of infection surveillance and control programs in preventing nosocomial infections in US hospitals. Am J Epidemiol 1985;121:182205.
6.Tambyah, P. Doing good and doing it well, especially where it is not easy. Infect Control Hosp Epidemiol 2010;31:142143.
7.Lynch, P, Pittet, D, Borg, MA, Mehtar, S. Infection control in countries with limited resources. J Hosp Infect 2007;65:148150.
8.Talaat, M, Kandeel, A, Rasslan, O, et al. Evolution of infection control in Egypt: achievements and challenges. Am J Infect Control 2006;34:193200.
9.El-Kholy, A, Saied, T, Gaber, M, et al. Device-associated nosocomial infection rates in intensive care units at Cairo University hospitals—first step towards initiating surveillance programs in a resource-limited country. Am J Infect Control 2012;40:e216e220.
10.El-Nawawy, AA, Abd El-Fattah, MM, El-Raouf Metwally, HA, El Din Barakat, SS, Hassan, IA. One year study of bacterial and fungal nosocomial infections among patients in pediatric intensive unit (PICU) in Alexandria. J Trop Pediatr 2005;52:185191.
11.Ahmed, SH, Daef, EA, Badary, MS, Mahmoud, MA, Abd-Elsayed, AA. Nosocomial blood stream infection in intensive care units at Assiut University Hospitals (Upper Egypt) with special reference to extended spectrum β-lactamase producing organisms. BMC Res Notes 2009;2:76.
12.Saied, T, Elkholy, A, Hafez, SF, et al. Antimicrobial resistance in pathogens causing nosocomial bloodstream infections in university hospitals in Egypt. Am J Infect Control 2011;39:e61e65.
13.National Healthcare Safety Network Patient Safety Component Manual. 17. Surveillance Definition of Healthcare-Associated Infection and Criteria for Specific Types of Infections in the Acute Care Setting. http://www.cdc.gov/nhsn/PDFs/pscManual/17pscNosInfDef_current.pdf. Accessed November 16, 2012.
14.National Healthcare Safety Network Patient Safety Component Manual. 15. CDC Location Labels and Location Descriptions. http://www.cdc.gov/nhsn/PDFs/pscManual/15LocationsDescriptions_current.pdf. Accessed November 16, 2012.
15.Magiorakos, A-P, Srinivasan, A, Carey, RB, et al. Multidrug-resistant, extensively drug-resistant and pandrug-resistant bacteria: an international expert proposal for interim standard definitions for acquired resistance. Clin Microbiol Infect 2012;18:268281.
16.Sievert, DM, Ricks, P, Edwards, JR, et al; National Healthcare Safety Network (NHSN) Team and Participating NHSN Facilities. Antimicrobial-resistant pathogens associated with healthcare-associated infections: summary of data reported to the National Healthcare Safety Network at the Centers for Disease Control and Prevention, 2009-2010. Infect Control Hosp Epidemiol 2013;34:114.
17.O'Grady, NP, Alexander, M, Burns, LA, et al. Guidelines for the Prevention of Intravascular Catheter-Related Infections, 2011. http://www.cdc.gov/hicpac/BSI/BSI-guidelines-2011.html. Accessed July 29, 2013.
18.Healthcare Infection Control Practices Advisory Committee. Guideline for Prevention of Catheter-Associated Urinary Tract Infections, 2009. http://www.cdc.gov/hicpac/cauti/002_cauti_toc.html. Accessed July 29, 2013.
19.Tablan, OC, Anderson, LJ, Besser, R, Bridges, C, Hajjeh, R. Guidelines for preventing healthcare-associated pneumonia, 2003. MMWR Recomm Rep 2004;53(RR-3):136.
20.Coffin, SE, Klompas, M, Classen, D, et al. Strategies to prevent ventilator-associated pneumonia in acute care hospitals. Infect Control Hosp Epidemiol 2008;29(suppl 1):S31S40.
21.Magill, SS, McAllister, LM, Allen-Bridson, K, et al. Preliminary results of a healthcare-associated infection and antimicrobial use prevalence survey in 22 U.S. acute care hospitals. In: Program and Abstracts of the 2011 SHEA Annual Scientific Meeting. April 1-4, 2011; Dallas. Abstract LB10.
22.Durlach, R, McIlvenny, G, Newcombe, RG, et al. Prevalence survey of healthcare-associated infections in Argentina: comparison with England, Wales, Northern Ireland and South Africa. J Hosp Infect 2012;80:217223.
23.Dudek, MA, Horan, TC, Peterson, KD, Allen-Bridson, K, Morrell, G, Pollock, DA. National Healthcare Safety Network (NHSN) Report, Data Summary for 2010, Device-Associated Module. Centers for Disease Control and Prevention, http://www.cdc.gov/nhsn/PDFs/dataStat/NHSN-Report_2010-Data-Summary.pdf. Accessed November 16, 2012.
24.Baltimore, RS. Neonatal nosocomial infections. Semin Perinatol 1998;22:2532.

Incidence and Pathogen Distribution of Healthcare-Associated Infections in Pilot Hospitals in Egypt

  • Isaac See (a1) (a2), Fernanda C. Lessa (a1), Omar Abo ElAta (a3), Soad Hafez (a4), Karim Samy (a3), Amani El-Kholy (a5), Mervat Gaber El Anani (a5), Ghada Ismail (a6), Amr Kandeel (a7), Ramy Galal (a7), Katherine Ellingson (a1) and Maha Talaat (a3)...

Metrics

Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed