Nosocomial infection in critical care units comprises 20 to 25% of total nosocomial infections.
We prospectively studied 71 surgical patients admitted to the surgical intensive care unit (SICU). Over an 8 month period. 31 patients(44%) had at least one nosocomial infection and a total of 52 nosocomial infections developed. The most common
pathgen
was Acinetobacter (25%). More than 50% of the infections which occurred in the SICU were due to aerobic gram-negative bacilli. MRSA, increasing in incidence recently, made up 14% of the nosocomial infectious pathogens identified on our SICU. The
most
common infection pattern was peumonia(28%). Nosocomial urinary tract infection developed in 13 cases(18%) and all infected patients had a Foley catheter.
We analyzed several facters such as age, sex, SICU duration, APACHE II score, presence of infection on admission, use of prior antibiotics, various invasive devices and their durations, and presence of malignancy. Among these, SICU duration,
APACHE
II
score, presence of invasive devices and their durations were stastically significant risk factors. Patients, admitted to the SICU for over 8 days, developed nosocomial infection over 80% of the time. Patients who had APACHE II scores exceeding 10
points, developed nosocomial infections over 55% of the time. The mortality rate during the study period was 18% (13/71). In the infected group, the mortality rate was 39% (12/31) and 2.5(1/40) in the control group. A significant difference was
present
between the two groups.
An effort for preventing and reducing nesocomial infection is needed to reduce morbidity and mortality of critically ill patients in SICU.
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