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Incidence and Pathogen Distribution of Healthcare-Associated Infections in Pilot Hospitals in Egypt

Published online by Cambridge University Press:  02 January 2015

Isaac See ,
Fernanda C. Lessa ,
Omar Abo ElAta ,
Soad Hafez ,
Karim Samy ,
Amani El-Kholy ,
Mervat Gaber El Anani ,
Ghada Ismail ,
Amr Kandeel  and
Ramy Galal
...Show all authors
Isaac See*
Affiliation:
Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia
Fernanda C. Lessa
Affiliation:
Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
Omar Abo ElAta
Affiliation:
Infection Control Unit, Global Disease Detection and Response Program, US Naval Medical Research Unit No. 3, Cairo, Egypt
Soad Hafez
Affiliation:
Department of Infection Control, Alexandria University Hospitals, Alexandria, Egypt
Karim Samy
Affiliation:
Infection Control Unit, Global Disease Detection and Response Program, US Naval Medical Research Unit No. 3, Cairo, Egypt
Amani El-Kholy
Affiliation:
Infection Control Unit, Clinical Pathology and Pediatric Departments, Faculty of Medicine, Cairo University, Cairo, Egypt
Mervat Gaber El Anani
Affiliation:
Infection Control Unit, Clinical Pathology and Pediatric Departments, Faculty of Medicine, Cairo University, Cairo, Egypt
Ghada Ismail
Affiliation:
Department of Clinical Pathology, Ain Shams University Hospitals, Cairo, Egypt
Amr Kandeel
Affiliation:
Ministry of Health and Population, Cairo, Egypt
Ramy Galal
Affiliation:
Ministry of Health and Population, Cairo, Egypt
Katherine Ellingson
Affiliation:
Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
Maha Talaat
Affiliation:
Infection Control Unit, Global Disease Detection and Response Program, US Naval Medical Research Unit No. 3, Cairo, Egypt
*
Centers for Disease Control and Prevention, 1600 Clifton Road NE, Mailstop A-24, Atlanta, GA 30333 ([email protected])
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Abstract

Objective.

To report type and rates of healthcare-associated infections (HAIs) as well as pathogen distribution and antimicrobial resistance patterns from a pilot HAI surveillance system in Egypt.

Methods.

Prospective surveillance was conducted from April 2011 through March 2012 in 46 intensive care units (ICUs) in Egypt. Definitions were adapted from the Centers for Disease Control and Prevention's National Healthcare Safety Network. Trained healthcare workers identified HAIs and recorded data on clinical symptoms and up to 4 pathogens. A convenience sample of clinical isolates was tested for antimicrobial resistance at a central reference laboratory. Multidrug resistance was defined by international consensus criteria.

Results.

ICUs from 11 hospitals collected 90,515 patient-days of surveillance data. Of 472 HAIs identified, 47% were pneumonia, 22% were bloodstream infections, and 15% were urinary tract infections; case fatality among HAI case patients was 43%. The highest rate of device-associated infections was reported for ventilator-associated pneumonia (pooled mean rate, 7.47 cases per 1,000 ventilator-days). The most common pathogens reported were Acinetobacter species (21.8%) and Klebsiella species (18.4%). All Acinetobacter isolates tested (31/31) were multidrug resistant, and 71% (17/24) of Klebsiella pneumoniae isolates were extended-spectrum β-lactamase producers.

Conclusions.

Infection control priorities in Egypt should include preventing pneumonia and preventing infections due to antimicrobial-resistant pathogens.

Type
Original Article
Information
Infection Control & Hospital Epidemiology , Volume 34 , Issue 12 , December 2013 , pp. 1281 - 1288
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2013

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References

1.Klevens, RM, Edwards, JR, Richards, CL Jr, et al. Estimating health care-associated infections and deaths in U.S. hospitals, 2002. Public Health Rep 2007;122:160–166.Google Scholar
2.Burton, DC, Edwards, JR, Horan, TC, Jernigan, JA, Fridkin, SK. Methicillin-resistant Staphylococcus aureus central line-associated bloodstream infections in US intensive care units, 19972007. JAMA 2009;301:727–736.Google Scholar
3.Burton, DC, Edwards, JR, Srinivasan, A, Fridkin, SK, Gould, CV. Trends in catheter-associated urinary tract infections in adult intensive care units—United States, 1990-2007. Infect Control Hosp Epidemiol 2011;32:748–756.Google Scholar
4.Allegranzi, B, Nejad, SB, Combescure, C, et al. Burden of endemic health-care-associated infection in developing countries: systematic review and meta-analysis. Lancet 2011;377:228–241.Google Scholar
5.Haley, RW, Culver, DH, White, JW, et al. The efficacy of infection surveillance and control programs in preventing nosocomial infections in US hospitals. Am J Epidemiol 1985;121:182–205.Google Scholar
6.Tambyah, P. Doing good and doing it well, especially where it is not easy. Infect Control Hosp Epidemiol 2010;31:142–143.Google Scholar
7.Lynch, P, Pittet, D, Borg, MA, Mehtar, S. Infection control in countries with limited resources. J Hosp Infect 2007;65:148–150.Google Scholar
8.Talaat, M, Kandeel, A, Rasslan, O, et al. Evolution of infection control in Egypt: achievements and challenges. Am J Infect Control 2006;34:193–200.Google Scholar
9.El-Kholy, A, Saied, T, Gaber, M, et al. Device-associated nosocomial infection rates in intensive care units at Cairo University hospitals—first step towards initiating surveillance programs in a resource-limited country. Am J Infect Control 2012;40:e216–e220.Google Scholar
10.El-Nawawy, AA, Abd El-Fattah, MM, El-Raouf Metwally, HA, El Din Barakat, SS, Hassan, IA. One year study of bacterial and fungal nosocomial infections among patients in pediatric intensive unit (PICU) in Alexandria. J Trop Pediatr 2005;52:185–191.Google Scholar
11.Ahmed, SH, Daef, EA, Badary, MS, Mahmoud, MA, Abd-Elsayed, AA. Nosocomial blood stream infection in intensive care units at Assiut University Hospitals (Upper Egypt) with special reference to extended spectrum β-lactamase producing organisms. BMC Res Notes 2009;2:76.Google Scholar
12.Saied, T, Elkholy, A, Hafez, SF, et al. Antimicrobial resistance in pathogens causing nosocomial bloodstream infections in university hospitals in Egypt. Am J Infect Control 2011;39:e61–e65.Google Scholar
13.National Healthcare Safety Network Patient Safety Component Manual. 17. Surveillance Definition of Healthcare-Associated Infection and Criteria for Specific Types of Infections in the Acute Care Setting. http://www.cdc.gov/nhsn/PDFs/pscManual/17pscNosInfDef_current.pdf. Accessed November 16, 2012.Google Scholar
14.National Healthcare Safety Network Patient Safety Component Manual. 15. CDC Location Labels and Location Descriptions. http://www.cdc.gov/nhsn/PDFs/pscManual/15LocationsDescriptions_current.pdf. Accessed November 16, 2012.Google Scholar
15.Magiorakos, A-P, Srinivasan, A, Carey, RB, et al. Multidrug-resistant, extensively drug-resistant and pandrug-resistant bacteria: an international expert proposal for interim standard definitions for acquired resistance. Clin Microbiol Infect 2012;18:268–281.Google Scholar
16.Sievert, DM, Ricks, P, Edwards, JR, et al; National Healthcare Safety Network (NHSN) Team and Participating NHSN Facilities. Antimicrobial-resistant pathogens associated with healthcare-associated infections: summary of data reported to the National Healthcare Safety Network at the Centers for Disease Control and Prevention, 2009-2010. Infect Control Hosp Epidemiol 2013;34:1–14.Google Scholar
17.O'Grady, NP, Alexander, M, Burns, LA, et al. Guidelines for the Prevention of Intravascular Catheter-Related Infections, 2011. http://www.cdc.gov/hicpac/BSI/BSI-guidelines-2011.html. Accessed July 29, 2013.Google Scholar
18.Healthcare Infection Control Practices Advisory Committee. Guideline for Prevention of Catheter-Associated Urinary Tract Infections, 2009. http://www.cdc.gov/hicpac/cauti/002_cauti_toc.html. Accessed July 29, 2013.Google Scholar
19.Tablan, OC, Anderson, LJ, Besser, R, Bridges, C, Hajjeh, R. Guidelines for preventing healthcare-associated pneumonia, 2003. MMWR Recomm Rep 2004;53(RR-3):1–36.Google Scholar
20.Coffin, SE, Klompas, M, Classen, D, et al. Strategies to prevent ventilator-associated pneumonia in acute care hospitals. Infect Control Hosp Epidemiol 2008;29(suppl 1):S31–S40.Google Scholar
21.Magill, SS, McAllister, LM, Allen-Bridson, K, et al. Preliminary results of a healthcare-associated infection and antimicrobial use prevalence survey in 22 U.S. acute care hospitals. In: Program and Abstracts of the 2011 SHEA Annual Scientific Meeting. April 1-4, 2011; Dallas. Abstract LB10.Google Scholar
22.Durlach, R, McIlvenny, G, Newcombe, RG, et al. Prevalence survey of healthcare-associated infections in Argentina: comparison with England, Wales, Northern Ireland and South Africa. J Hosp Infect 2012;80:217–223.Google Scholar
23.Dudek, MA, Horan, TC, Peterson, KD, Allen-Bridson, K, Morrell, G, Pollock, DA. National Healthcare Safety Network (NHSN) Report, Data Summary for 2010, Device-Associated Module. Centers for Disease Control and Prevention, http://www.cdc.gov/nhsn/PDFs/dataStat/NHSN-Report_2010-Data-Summary.pdf. Accessed November 16, 2012.Google Scholar
24.Baltimore, RS. Neonatal nosocomial infections. Semin Perinatol 1998;22:25–32.Google Scholar