Abulhasan YB, et al. - Researchers performed a prospective cohort study to report the incidence rates, pathogen distribution, and patient-related outcomes of Healthcare-associated infections (HAIs) in a neurological intensive care units (neuro-ICUs) population. They observed an increase in length of stay in association with neuro-ICU HAIs. In high-risk neurocritical care categories, VAP remained most prevalent. Rates of infection and resistance organisms were very low due to infection prevention and control strategies. They strongly recommended daily consideration of indwelling devices in the neuro-ICU.

Methods

• Researchers used laboratory results and specific clinical indicators to categorize infections as per National Healthcare Safety Network nosocomial infection surveillance definitions.
• They assessed the patient outcomes including length of stay and mortality.

Results

• Over the 6-year study period, 6,033 neuro-ICU admissions resulting in 20,800 neuro-ICU days were observed.
• Researchers identified a total of 227 HAIs for a rate of 10.9/1,000 ICU days.
• In this study, device-associated infections accounted for 80.6% of HAIs, with incidence rates (per 1,000 device days) being 18.4 for ventilator-associated pneumonia; 4.9 for catheter-associated urinary tract infections (CAUTIs); 4.0 for ventriculostomy-associated infections; and 0.6 for central line-associated blood stream infections (CLABSIs).
• Subdural hematoma and intracerebral/intraventricular hemorrhage were linked with the highest pooled HAIs among the various diagnostic categories, with incidence rates of 21.3 and 21.1 per 1,000 neuro-ICU days, respectively.
• They observed a strong association of prolonged neuro-ICU length of stay with all HAIs.