A surveillance component system for Intensive Care Units (ICUs) designed to account for major extrinsic risk factors for
nosocomial infections using device days as the denominator has been advocated. A study of the surveillance component system in ICUs was conducted in Security Forces Hospital (SFH), Riyadh, Saudi Arabia, from February 1993 to January 1994 to verify the validity and compare the device-related
infection rates with the
infection rates based on
patient admission and patient days. The standard recommended method was used in data collection. Device-associated
infection rates vary by ICU types and device exposure. The surgical ICU (SICU) had the highest
pneumonia rate while the pediatric ICU (PICU) had the lowest, being 22.0 and 6.4 per 1000
ventilator days respectively.
Bacteremia was highest in the PICU with 20.7/1000 intravascular
catheter days. The
urinary tract infection rate of 11.4/1000
urinary catheter days was the highest in the medical ICU (MICU). These were statistically significant (P>0.001). The conclusion from the demonstration of these variables is that the use of the surveillance component system gives specific information on the effect of invasive devices in the occurrence of
infection related to their use in the various ICUs. It permits the calculation of risk-specific
infection rates, being a marker for the unit's invasive practices. Improved handwashing and the wearing of sterile gloves reduced the central intravascular
catheter bacteremia rate in PICU from 20.7 to 10.0/1000
catheter days.