Diagnosis of Health-Care Associated Infections in Adult Patients Admitted in Internal Medicine Hospital of Cairo University

Background: Healthcare associated infections (HAIs) are common cause of morbidity and mortality and are among the most common adverse events in healthcare worldwide with a major problem of high cost for their management. Objectives: Diagnosis and estimation of hospital infections including device-associated infections (DAIs) in medical wards and ICU. Patients and Methods: This is a one year surveillance study which included 1975 patients (52.3% males 47.7% females) admitted to 3 Medical wards ICU and hospitalized for ³72 hours. All patients were screened daily for development of new respiratory and/or diarrheal symptoms. Also, devise associated infections (DAIs) including central-line-associated blood stream infections (CLABSI), urinary catheter-associated urinary tract infections (CAUTI) and ventilator-associated pneumonia (VAP) were included in this study. Surveillance sheets and forms were used for collecting clinical, laboratory, and other diagnostic informations. Different samples (urine, stool, blood, nasopharyngeal/oropharyngeal swabs bronchoalveolar lavage) were collected from patients according to their clinical situation and subjected to further laboratory work up. Results: Only one patient out of 19 who developed respiratory symptoms had a positive swab for RSV. Five cases had diarrhea after 3 days of admission but all were negative for Clostridium difficile. Also we found 11/246 of ICU patients infected with VAP. As regards the rate of CLABSI, we found 15 affected cases, of them (9/263) (3.4%) in the ICU and 6/272 (2.2%) in the medical wards. However regarding CAUTI, we found only 5 affected cases during our surveillance, 4/267 cases in the ICU and 1/258 case in the medical wards. Conclusion: The rate of hospital acquired respiratory tract infection was 1.06% while for diarrhea secondary to Cl. Difficile it was 0.0%. This is comparable to studies done in other hospitals. The rates of device associated infections and their related mortality were higher in ICU than in medical wards.