ABSTRACT
To determine the rate of device-associated healthcare-associated infections [DA-HAIs] at a respiratory intensive care unit [RICU] and in the pediatric intensive care units [PICUs] of member hospitals of the International Nosocomial Infection Control Consortium [INICC] in Egypt. A prospective cohort DA-HAI surveillance study was conducted from December 2008 to July 2010 by applying the methodology of the INICC and the definitions of the NHSN-CDC. In the RICU, 473 patients were hospitalized for 2930 d and acquired 155 DA-HAIs, with an overall rate of 32.8%. There were 52.9 DA-HAIs per 1000 ICU-days. In the PICUs, 143 patients were hospitalized for 1535 d and acquired 35 DA-HAIs, with an overall rate of 24.5%. There were 22.8 DA-HAIs per 1000 ICU-days. The central line-associated blood stream infection [CLABSI] rate was 22.5 per 1000 line-days in the RICU and 18.8 in the PICUs; the ventilator-associated pneumonia [VAP] rate was 73.4 per 1000 ventilator-days in the RICU and 31.8 in the PICUs; and the catheter-associated urinary tract infection [CAUTI] rate was 34.2 per 1000 catheter-days in the RICU. DA-HAIs in the ICUs in Egypt pose greater threats to patient safety than in industrialized countries, and infection control programs, including surveillance and guidelines, must become a priority
ABSTRACT
Hospital-acquired infections affect 5% to 10% of all hospitalized patients, and are the most common cause of preventable morbidity and mortality facing health care. It is estimated that 30% of hospitalacquired infections are avoidable with healthcare provider adherence to hand hygiene [HH] guidelines .Thus preventing patient-to-patient and healthcare worker-to-patient transmission of microorganisms can prevent most nosocomial infections. This work was conducted to study the effect of HH practices on hospital-acquired infections in the Respiratory Intensive Care Unit [RICU] at Ain Shams University Hospital. The study was done in three phases; the first was an observational study for HH practices among physicians and nurses and evaluation of HH resources during the period from December, 2008 to March, 2009, so termed pre-intervention phase. The second was the intervention phase, started by education and on job training for HH practices among physicians and nurses together with replenishing of HH resources in a two months period from April to May 2009. The third was the post-intervention phase, which extended from June to December 2009. The infection rates were calculated through the three phases and re-evaluation of the intervention was carried out by calculating the compliance rates before and after intervention. HH compliance increased significantly from 8.2% in the pre-intervention phase to 53.9% in postintervention phase. The HH practices increased in nurses more than doctors, nurses' compliance in preintervention phase was 42.4% and increased to 70.7% in the post-intervention phase. Doctors' compliance increased from 36.8% in pre-intervention to 55.3% in post-intervention. Overall patient infection rates declined from 63.7% to 50.2% during the study. Such simple, non costly methodologies can increase the compliance of HH practices which can decrease infection rates in RICU