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

Published online by Cambridge University Press:  02 January 2015

Isaac See ,
Fernanda C. Lessa ,
Omar Abo ElAta ,
Soad Hafez ,
Karim Samy ,
Amani El-Kholy ,
Mervat Gaber El Anani ,
Ghada Ismail ,
Amr Kandeel  and
Ramy Galal
...Show all authors
Isaac See*
Affiliation:
Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia
Fernanda C. Lessa
Affiliation:
Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
Omar Abo ElAta
Affiliation:
Infection Control Unit, Global Disease Detection and Response Program, US Naval Medical Research Unit No. 3, Cairo, Egypt
Soad Hafez
Affiliation:
Department of Infection Control, Alexandria University Hospitals, Alexandria, Egypt
Karim Samy
Affiliation:
Infection Control Unit, Global Disease Detection and Response Program, US Naval Medical Research Unit No. 3, Cairo, Egypt
Amani El-Kholy
Affiliation:
Infection Control Unit, Clinical Pathology and Pediatric Departments, Faculty of Medicine, Cairo University, Cairo, Egypt
Mervat Gaber El Anani
Affiliation:
Infection Control Unit, Clinical Pathology and Pediatric Departments, Faculty of Medicine, Cairo University, Cairo, Egypt
Ghada Ismail
Affiliation:
Department of Clinical Pathology, Ain Shams University Hospitals, Cairo, Egypt
Amr Kandeel
Affiliation:
Ministry of Health and Population, Cairo, Egypt
Ramy Galal
Affiliation:
Ministry of Health and Population, Cairo, Egypt
Katherine Ellingson
Affiliation:
Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
Maha Talaat
Affiliation:
Infection Control Unit, Global Disease Detection and Response Program, US Naval Medical Research Unit No. 3, Cairo, Egypt
*
Centers for Disease Control and Prevention, 1600 Clifton Road NE, Mailstop A-24, Atlanta, GA 30333 (isee@cdc.gov)
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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.

Type
Original Article
Information
Infection Control & Hospital Epidemiology , Volume 34 , Issue 12 , December 2013 , pp. 1281 - 1288
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2013

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