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

Isaac See MD, Fernanda C. Lessa MD, Omar Abo ElAta MD MPH, Soad Hafez PhD MS MBBCh, Karim Samy RPh BPS, Amani El-Kholy MD PhD, Mervat Gaber El Anani MD PhD, Ghada Ismail MD PhD, Amr Kandeel MD MPH PhD, Ramy Galal MD MPH, Katherine Ellingson PhD and Maha Talaat MD MPH DrPH
Infection Control and Hospital Epidemiology
Vol. 34, No. 12 (December 2013), pp. 1281-1288
DOI: 10.1086/673985
Stable URL: http://www.jstor.org/stable/10.1086/673985
Page Count: 8
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Incidence and Pathogen Distribution of Healthcare-Associated Infections in Pilot Hospitals in Egypt
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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.

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