الفهرس 
Review of literatureOnly 14 pages are availabe for public view
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Abstract
The HAIs constitute a serious problem in healthcare services as they are common causes of morbidity and mortality among hospitalized patients. Currently, between 5% and 10% of patients admitted to acute care hospitals acquire at least one infection. HAIs may be attributed to by host, microbial and environmental factors. The HAIs can lead to disabling conditions that reduce the quality of life, also the increased length of stay for infected patients and excess use of antibiotics are great contributors to increased economic burden.
Medical devices are responsible for most of nosocomial infections in critically-ill patients. DAI can cause major medical and economic sequelae. The greatest threat against safety in the ICU is from DAI, particularly VAP, CLABSI, and CAUTI.
This study was conducted as a prospective incidence-based surveillance on 303 adult and neonatal ICUs in Beni-Suef University Hospital , over a period of 12 months from June 2012 to May 2013.
Demographic, clinical data, APACHE II score for adults, and patients’ outcome were recorded for all patients. Cultures of urine, blood and BAL were performed for bacteriological identification of causative organisms of CAUTI, CLABSI and VAP respectively and the diagnosis was made according to CDC/NHSN case definition.
Total patients days and device days were recorded and DAI rate/1000 device days, DU ratio and crude extra mortality rates were calculated for patients with device inserted.
The overall rate of DAIs was (30.5/1000 device days) in adult ICU lower than neonatal ICU which was (58/1000 device days).
The VAP was the most frequently identified infection in two ICUs, (77.7/1000 device days) in neonatal ICU, (68.7/1000 device days) in adult ICU .
The results of CLABSI, VAP and CAUTI rates were higher than NHSN rates despite the fact that our device utilization was lower than both NHSN and INICC reports.
Increased LOS and device days showed significant differences. Lack of implementation of DAI prevention bundles and inadequate compliance to hand hygiene policy are possible contributing factors to the high DAI rates. Additionally patients with DAIs had significantly higher crude extra mortality rates than non-infected.
The most common causative organisms in CLABSI patients (adult and neonatal) of our study were Klebsiella Spp.(38.4%) followed by Pseudomonus Spp.(15.4%) and Enterococcus Spp.(15.4%)
The commonest organisms in adult and neonatal VAP patients were Acinetobacter and Klebsiella Spp. (38.8%) .In adult CAUTI patients the most commonly isolated organism was Candida spp.(37%).