PROSPECTIVE-STUDY OF NOSOCOMIAL INFECTION IN A MEDICAL ICU - A PROPOSAL FOR THE GENERALIZED USE OF THE NATIONAL NOSOCOMIAL INFECTION SURVEILLANCE SYSTEM RATES

Objective. To know the more relevant nosocomial infection (NI) rates i n our Intensive Care Unit (ICU), risk factors associated with NI and t rends in the infective flora. Methods. During a three-month period, th e cumulative incidence, density of overall incidence and device associ ated infection rates were determined in a total of 308 patients admitt ed to the medical ICU, following the recommendations of the National N osocomial Infection Surveillance System (NNIS) in the USA. Results. Th e cumulative incidence was 8.4 infections per 100 admissions. The dens ity of overall incidence was 12.9 nosocomial infections per 1,000 days of ICU stay. Device-associated infection rates were: 28.9 pneumonia p er 1,000 mechanical ventilation days, 5.3 urinary tract infections per 1,000 days of catheter use and 0.4 bacteremia per 1,000 days of centr al venous catheter. Pneumonia was the more common NI, followed by urin ary tract infection. Pseudomonas aeruginosa was the microorganism reco vered most frequently. The most common used antibiotics were third gen eration cephalosporins, followed by quinolones and macrolides. Conclus ions. The use of NNIS rates is advisable because its allows to know th e impact of NI on our unit and to perform comparative studies with oth er units of similar characteristics.