Ecological and epidemiological features nosocomial infections in intensive care unit

Abstract

Introduction: Nosocomial infections complicate carrying out medical and diagnostic process, sharply reduce efficiency and enlarge hospitalization duration, raise lethality, leading as a whole to augmentation of economic expenses and causing essential social damage. Purpose and Objectives: To analyze the ecological and epidemiological characteristics of pathogens causing nosocomial infections in the intensive care unit. Material and methods: We examined analysis of 122 isolates from 42 patients aged 10 to 71 years, treated in an intensive care unit multidisciplinary hospital. The research materials are tracheal swabs, wounds, pressure sores, washouts from drainage tubes. Results: In etiological structure of hospital infection in the ICU prevail gram-negative microorganisms (76,23%): Enterobacter cloacae (32,79%), Pseudomonas aeruginosa (21,31%) and Acinetobacter lwoflfi (18,03%), predominantly in the form of monocultures. The microbial associations were found. Associations, circulating at the hospital, have low coefficient of associativity (kA = 25,66%), between microorganisms exist opposing relationship, therefore, they are unstable and capable to exist short time (Jaccard coefficient - 7,66%). To reduce the frequency of infectious complications must take into account the mechanisms of antibiotic resistance leading pathogens. Particular attention should be paid to resistance to Cefotaxime, Ceftazidime and Cefepime at the leading number of microorganisms. To Pseudomonas aeruginosa pay attention to resistance to Ciprofloxacin, as well as resistance to Imipenem, Meropenem and Carbenicillin. Clinical and epidemiological characteristics of nosocomial infections in ICU patients were: the senior age group of risk (50 years and over); leading purulent septic complications-purulent tracheobronchitis, bilateral pneumonia; higher frequency surgical interventions and the intensity of antibiotic therapy; prolonged hospitalization; the later dates of occurrence; conducted a large number of invasive procedures. Conclusion: Nosocomial infections are one of the most serious problems in epidemiology. The epidemiological situation demands attentive studying and introduction of new systems of infectious control for modification in the style and operating mode in departments of resuscitation and intensive care.