1b - Healthcare-associated infections in Intensive Care Units: prevalence and associated factors

Background : Healthcare-associated infections (HAIs) represent a serious and frequent problem in intensive care units (ICUs). Many factors could be potentially involved through invasive medical procedures which are required on patients who are most often in critical condition.In this context, our study aimed to determine the prevalence of HAIs in ICUs and to identify their associated factors.

Methods : We conducted a cross-sectional survey between February and March 2023 in the ICUs of the two University Hospitals in Southern Tunisia.We included all patients who were present at 8:00 a.m. on the day of the survey. HAIs were defined according to the criteria of the Centers for Disease Control and Prevention. The ICUs included medical, surgical, and pediatric ICUs, emergency medical aid services, and neonatology departments.

Results : We recorded 18 cases of HAIs among 90 patients investigated in the ICUs. The prevalence of HAIs was 20%. The sex ratio was 1.72. The median age was 58 years(Interquartile range(IQR)=[42.5-70.5]). The median length of stay was four days(IQR=[2-11]). Sepsis was the most common HAI(8 cases; 44.4%).A length of stay greater than or equal to seven days was significantly associated with the occurrence of HAIs(77.8% VS 22.2%;Odds ratio(OR)=6.58;p=0.001).In addition, HAIs were significantly more frequent in patients with hypertension(37.9% VS 11.5%;OR=4.71; p=0.003)and diabetes(35.7% VS 12.9%;OR=3.75;p=0.012). Moreover, HAIs were significantly associated with the installation of invasive medical devices, such as central venous vascular catheter(37.9% VS 25%;OR=4.71;p=0.003), intubation(41.2% VS 15.1%;OR=3.9;p=0.037), mechanical ventilation(30.8% VS 11.8%;OR=3.33;p=0.026),as well as bladder catheter(30% VS 12%;OR=3.14;p=0.034).

Conclusions We noted high rates of HAIs in the ICUs in our hospitals. A global policy for the prevention and control of HAIs is urgent, the pillars of which will certainly be compliance by staff with hygiene precautions.