Device-associated, device-day infection rates in an Israeli adult general intensive care unit

Surveillance is an essential element of hospital infection control programs . Previous studies have shown that interhospital comparison of intensive ca re unit (ICU) nosocomial infections (NI) may be best made by comparing ICU- type-specific, device-associated infection rates and that these adjusted ra tes vary by ICU type. The aim of this study was to evaluate whether signifi cant structural improvements introduced in an adult general ICU were associ ated with changes in the NI rates in this unit. In addition, we compared th ese rates with those of ICUs reported by the National Nosocomial Infections Surveillance (NNIS) System of the Centers for Diseases Control and Prevent ion. During a 12-month period 337 patients were surveyed. There were 20 ven tilator-associated pneumonias (VAP)/1000 ventilator (VEN)-days, 12 bloodstr eam infections (BSI)/1000 central vascular catheter (CVC)-days and 14 urina ry tract infection (UTI)/1000 indwelling urinary catheter (ICC)-days. Struc tural changes and reduction in device utilization ratios were not followed by change in NI rates in this unit. VAP and BSI rates were comparable to th ose reported for neurosurgical and burn ICUs, respectively, in the NNIS Sys tem, despite a much higher device utilization ratios. The present study pro vides specific surveillance data for further interhospital comparison vith similar types of ICUs. (C) 2000 The Hospital Infection Society.