The prevalence of healthcare-associated infection in medical intensive care units in tunisia. Results of the multi-centre nosorea1 study.

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Published Nov 15, 2018
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Vol. 96 No. 10 (2018): Issue Oct 2018

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A. Jamoussi
S. Ayed
K. Ben Ismail
K. Chtara
M. Bouaziz
A. Mokline
A. Messaadi
T. Merhebene
N Tilouche
S. El Atrous
M. Boussarsar
F. Daly
S. Benlakhel
I. Fathallal
N Kouraichi
Y.Z. El Hechmi
Z. Jerbi
R. Attigue
H. Hamouda
H. Ghadhoun
H. El Ghord
K. Ben Romdhane
S. Khedher
R. Allala
H. Mateur
N. Brahmi
J. Ben Khelil
M. Besbes

Abstract

Objectives: To determine the prevalence of Healthcare-Associated Infection (HAI) in medical Intensive Care Unit (ICU), risk factors for these infections and identify the predominant infecting organisms.
Methods: A 1-day point-prevalence study within all medical ICUs in Tunisia, all patients occupying an ICU bed over a 48-hour period were included. Rates of HAI, resistance patterns of microbiological isolates and potential risk factors for HAI were recorded.
Results: One hundred and three patients were collected from 15 Tunisian medical ICUs. HAI prevalence was 25.2% CI 95% [15-35].The most frequent HAIs were hospital acquired pneumonia in 19 cases (59%) and catheter related infection in 5 cases (15%). Independent factors associated with HAI occurrence were SAPSII score ≥ 33 with OR 1.047; CI 95% [1.015-1.077], p=0.003 and recent hospitalization with OR 4.14 CI 95% [1.235-13.889], p=0.021. Non-fermenting pathogens were the most frequent microorganisms reported in ICUs ecology, prior colonization and HAIs of the screened patients.
Conclusion: HAIs are frequent in medical ICUs in Tunisia, which emphasize the importance of specific measures for surveillance and infection control in critically ill patients. Implementing a national monitoring system of HAI should be a major priority of public health in Tunisia.

Keywords:

Iatrogenic Disease - Cross Infection - Intensive Care Units - Critical Care - Prevalence -Risk Factors - Acinetobacter baumannii

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