ABSTRACT
Device associated infections [DAIs] are considered the principal threat to patient safety in the ICU, and among the main causes of patient morbidity and mortality. To determine the DAI rates, as well as to identify the infectious agents isolated and their antimicrobial resistance patterns in the surgical ICU of Ain Sham University Hospital. The numbers of total patient days, ventilator days, urinary catheter days, and central catheter days in the ICUs were recorded during the period from June to November 2013. DAI rates and device utilization ratios were calculated. Clinical specimens were obtained from infected patients, cultured onto suitable media and isolates were identified using conventional methods. Antimicrobial susceptibilities of the isolates were investigated according to the standards of the Clinical and Laboratory Standards Institute. Totally 152DAIs were determined with a rate of 24.43/1, 000device days. The device utilization ratios were as follows: [0.75] for urinary catheter, [0.54] for mechanical ventilator, and [0.41] for central line. Ventilator associated pneumonia rate was 26.07/1, 000 ventilator days and most common microorganism was K.pneumoniae. Catheter associated urinary infection rate was 25.3/1, 000 urinary catheter days and the most common pathogen was E.coli. Central catheter associated blood stream infection rate was 19.84/1, 000 central catheter days and the most common infecting organism was S.aureus. Among Staphylococcus spp., 60.52% of S.aureus isolates and 50% of coagulase negative Staphylococci were methicillin resistant. ESBL production rates were 27.77% in E.coli, 27.6% in P.aeuroginosa, and 20.83% in K.pneumoniae isolates. The high rates of DAIs, device utilization ratios, and levels of antimicrobial resistance of pathogens identified in this study, highlight the importance of establishing antimicrobial stewardship and an active surveillance program, developing a comprehensive education program on evidence-based approaches for all health care workers, decreasing device utilization and the implementation of care bundles