An evaluation of culture-positive infections and risk factors in patients admitted to the ICU of Imam Reza hospital in Birjand, Iran in 2015-2016

Introduction:Culture-positive infections include a broad range of nosocomial infections in the intensive care unit (ICU). Investigation and control of these infections is a global priority that aims to minimize infections in order to reduce mortality, decrease the length of stay in the hospital and also significantly reduce the cost of treatment. The purpose of this study was to investigate culture-positive infections and the risk factors in patients admitted to the ICU of Imam Reza (AS) hospital in Birjand. Methods:In this cross-sectional study (descriptive-analytical), all patients admitted to the ICU at Imam Reza hospital in 2015 were enrolled in the study. The patients’ blood, urine, wounds and sputum samples were taken to culture upon their admission and CSF cultures were performed when needed. People who initially had positive cultures, as well as those who were pre-treated with antibiotics, as well as those who or their family did not agree to participate, were excluded from the study. In culture negative cases, 48-72 hours after admission, cultures were repeated. Risk factors such as underlying disease, age, gender, duration of hospitalization and the use of catheters were evaluated in positive samples. Data analysis was performed by SPSS v.18 software and using Chi-square test. Results:A total of 669 patients with an average age of 46.12 ± 26.08 years were enrolled in the study. The average length of stay was 4.8 ± 8.11 days. The incidence rate of nosocomial infection in patients was 68 (10.2%). Respiratory infection with 79.3% was the most common source of infection. Surgical wound infection with 44.1% and urinary tract infection with 23.5% were the next common types of infection. The most common isolated bacteria from urinary tract infections were Escherichia coli and Pseudomonas spp., while coagulase-negative staphylococcus and Klebsiella spp. were the most commonly isolated bacteria from other types of infections. The incidence of nosocomial infections correlated significantly with age, duration of hospitalization and risk factors such as central catheters, endotracheal tube, ventilator, chest tube, NG TUBE, ventilator and tracheostomy (P<0.05). Conclusions:According to the results of this study, more attention should be paid to the patients with culture-positive infections and to the reduction of associated risk factors. It is also recommended to avoid any unnecessary interventions in the ICU. In addition, in case of need for catheterization, care and hygiene practices are essential in order to prevent infections