Abstract

Background: Getting a nosocomial infection (NI) equals higher hospitalization costs, higher mortality and morbidity rates, and a tremendous financial burden both to the patients and the health care system. Therefore, the aim of this study was the epidemiology of nosocomial infections and its related factors in patients admitted to the intensive care unit of selected hospitals in Tehran.

Method and Materials: This study was conducted on all patients admitted from 2015 to 2017 to the intensive care unit (ICU) of selected hospitals in Tehran, Iran. The inclusion criteria for the study was having a confirmed NI. Confirmed NI was defined as a positive culture result during the first 48 hours of admission to intensive care unit. Demographic variables, hospitalization days before admitting to ICU, reason of admission, pathogen, site of infection, medical history and list of invasive were interventions used for patient. Confirmed cases were evaluated more to specify the underlying pathogen and the route of infection. Data were analyzed using R software version 4.0.2.

Result: In the beginning, 2055 patients were enrolled in the study and 307 patients (14.9%) were positive for nosocomial infections. The mean age in the patients with NIs was 66.9 and 52.9 in patients without NIs, which was significantly different between groups (p=0.00). We also found that days of hospitalization before ICU admission was significantly correlated with getting NIs (p=0.00). We organized them in five groups: Respiratory disorders, non-respiratory internal disorders, Trauma patients, neurosurgical disorders and other surgical complaints. As can be seen, patients with respiratory disorders were at significantly higher risk of getting a NI (OR=4.85, p=0.00). The risk of getting NI was lower for other patients, and it was at its lowest point for trauma patients (OR=0.17, p=0.00). Based on data, patients with CKD were at the highest risk of getting a NI, compared to other complications (OR=3.94, p=0.00). Also having a prior history of diabetes mellitus, myocardial infection, lymphoma, and any form of immunosuppression were significantly associated with a higher risk of getting a NI.

Conclusion: Lowering hospitalization by doing appropriate interventions as fast as possible, may decrease the risk of getting NIs. Also taking a complete and appropriate history from patients and perfect documentation is necessary for predicting NIs in them.

Key word: Epidemiology, Nosocomial Infections, Intensive Care Unit, Patients.