Infection control as a nonpharmacologic strategy for the prevention of healthcare-associated infections in a Ukrainian hospital

Introduction

Healthcare-associated infections (HAI) in ICU patients are related to intubation, mechanical ventilation, and central venous and/ or urinary catheters. The incidence of HAI is too high, and antibiotic strategies suffer from resistance to the common classes of antibacterial agents [1].

Methods

A complex program including staff teaching on the basic approaches of hand hygiene, microbiological passport of the ICU departments, and detection of the sources of the pathogens polluting the treatment area of the ICU was implemented at the Lugansk Regional Clinical Hospital. The incidence of the HAI was studied in polytrauma patients in 1999 to 2003 (before the implementation of the program) and in 2008 to 2012 (after its implementation).

Results

Before the implementation of the infection control program, the incidence of respiratory tract infections in polytrauma patients staying in ICUs was 57.4% of patients. Urinary infections occurred in 51.9% of patients. Surgical site infections were found in 32.8% of the patients. Combination of the infections was detected in 33.8% of patients. The incidence of the multiple-drug-resistant bacterial colonies was 5.8%.

In contrast, recent data obtained after the implementation of the program of the infection control showed that the respiratory infections occurred in 29.3% of the patients, catheter-related urinary tract infections were detected in 32.8%, and surgical site infections were detected in 8.6% of the polytrauma patients. On the other hand, the incidence of the multiple-drug-resistant bacterial colonies increased significantly up to 14.2% ( P < 0.001). Other types of HAI changed nonsignificantly.

Conclusion

In the era of the total antibacterial resistance, the education strategies and organization approaches (for example, infection control, antibiotic susceptibility, hand hygiene, and so forth) become more potent and effective than pharmacology innovations. Polytrauma patients, as one of the most severe categories suffering from the HAI, demand a high level of compliance of the infection control approaches from the side of doctors as well as staff of and visitors to ICUs.