Healthcare-associated infections acquired in intensive care units - Annual Epidemiological Report for 2018

In 2018, 9 860 (7.8%) of patients staying in an intensive care unit (ICU) for more than two days presented with at least one ICU-acquired healthcare-associated infection (HAI) under surveillance (pneumonia, bloodstream infection or urinary tract infection). Of all patients staying in an ICU for more than two days, 6% presented with pneumonia, 3% with bloodstream infection (BSI), and 2% with urinary tract infection (UTI).

Some 97% of pneumonia episodes were associated with intubation, 41% of BSI episodes were catheter-related, and 99% of UTI episodes were associated with the presence of a urinary catheter. The most frequently isolated microorganism was Pseudomonas aeruginosa in ICU-acquired pneumonia episodes, coagulase-negative staphylococci in ICU-acquired bloodstream infections, and Escherichia coli in ICU-acquired urinary tract infections.

Antimicrobial use was empirical in 59% of days of therapy (DOTs), directed in 25% of DOTs, and prophylactic in 12% of DOTs. 16% of Staphylococcus aureus isolates were oxacillin-resistant (MRSA) and 13% of Enterococcus spp. isolates were glycopeptide-resistant. Resistance to third-generation cephalosporins was reported in 15% of E. coli isolates, 40% of Klebsiella spp. isolates and 36% of Enterobacter spp. isolates. Carbapenem resistance was reported in 12% of Klebsiella spp. isolates, 28% of P. aeruginosa isolates and 71% of Acinetobacter baumannii isolates.