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Abstract
Introduction: Healthcare-associated infections (HAIs) are a major threat to patient safety, and are associated with high mortality rates. Important risk factors associated with HAIs are the use of invasive medical devices (e.g. central lines, urinary catheters and mechanical ventilators), and poor staff adherence to infection prevention practices during insertion and care for the devices when in place. AIM OF THE STUDY: Isolate and identify GNP causing SSIs and DAIs among ICU patients, recognize the association between different risk factors and development of HAIs, detect GNP resistance to carbapenem by DD and standard E-test, and evaluate the performance of Carba NP test with conducted multiplex conventional PCR. RESULT: The study included 851 patients admitted to ICU over a year. Eighty patients developed DAIs while using certain devices and/or had history of SSIs after performing surgical procedure during their ICU admission. SSI was the most predominant infection among ICU patients (33%) followed by CAUTI which represented (25%) of infected patients. About (71%) of DAIs and SSIs caused by Gram-negative pathogens. The most prevalent organisms were P. aeruginosa (21%) followed by Acinetobacter (19%). Out of these isolated Gram-negative pathogens, (64.7%) showed decreased susceptibility to carbapenem. (65%) of these resistant pathogens showed carbapenemase production. Previous history of hospitalization, length of hospital stay, patients with more than one device especially with central line and patients with operations were more vulnerable to acquired HAIs. Disc diffusion according interpretation of CLSI, 2015 recommendations had sensitivity and specificity (100% and 92.3% respectively) to predict carbapenem-resistant isolates when compared with E-test results. PCR revealed that the commonest carbapenemase gene were NDM (46.7%) followed by KPC (30%) among isolated resistant GNP. Carba NP test results showed sensitivity and specificity (73.5% and 100% respectively) when compared with the used PCR method to detect carbapenemase production in GNP