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Surveillance of Nosocomial Infections in a Neurologic Intensive Care Unit

Published online by Cambridge University Press:  21 June 2016

Dirk Zolldann
Affiliation:
Department of Infection Control, Aachen University Hospital, Aachen, Germany
Christoph Spitzer
Affiliation:
Department of Neurology, Aachen University Hospital, Aachen, Germany
Helga Häfner
Affiliation:
Department of Infection Control, Aachen University Hospital, Aachen, Germany
Birgit Waitschies
Affiliation:
Department of Infection Control, Aachen University Hospital, Aachen, Germany
Wolfgang Klein
Affiliation:
Department of Neurology, Aachen University Hospital, Aachen, Germany
Dorit Sohr
Affiliation:
Institute for Hygiene, Free University of Berlin, Berlin, Germany
Frank Block
Affiliation:
Department of Neurology, Aachen University Hospital, Aachen, Germany
Rudolf Lütticken
Affiliation:
Institute of Medical Microbiology, Aachen University Hospital, Aachen, Germany
Sebastian W. Lemmen
Affiliation:
Department of Infection Control, Aachen University Hospital, Aachen, Germany
Corresponding
E-mail address:

Abstract

Objective:

To assess data on the epidemiology of nosocomial infection (N1) among neurologic intensive care patients.

Design:

Prospective periodic surveillance study.

Setting:

An 8-bed neurologic intensive care unit (ICU).

Patients:

All those admitted for more than 24 hours during five 3-month periods between January 1999 and March 2003.

Methods:

Standardized surveillance within the German infection surveillance system.

Results:

Three hundred thirty-eight patients with a total of 2,867 patient-days and a mean length of stay of 8.5 days were enrolled during the 15-month study period. A total of 71 NIs were identified among 52 patients. Urinary tract infections (UTIs) were the most frequent N1 (36.6%), followed by pneumonia (29.6%) and bloodstream infections (BSIs) (15.5%). The overall incidence and incidence density of NIs were 21.0 per 100 patients and 24.8 per 1,000 patient-days, respectively. Incidence densities were 9.8 UTIs per 1,000 urinary catheter-days (CI95, 6.4-14.4), 5.6 BSIs per 1,000 central venous catheter-days (CI95, 2.8-10.0), and 12.8 cases of pneumonia per 1,000 ventilation-days (CI95, 8.0-19.7). Device-associated UTI and pneumonia rates were in the upper range of national and international reference data for medical ICUs, despite the intensive infection control and prevention program in operation in the hospital.

Conclusion:

Neurologic intensive care patients have relatively high rates of device-associated nosocomial pneumonia and UTI. For a valid comparison of surveillance data and implementation of targeted prevention strategies, we would strongly recommend provision of national benchmarks for the neurologic ICU setting.

Type
Original Articles
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2005

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