Nosocomial infections in an intensive care unit: predisposing role of enteral feeding tube in critically ill patients

Background: Healthcare-Associated Infections (HAIs) are a major issue in the Intensive Care Units (ICU). In this context it is of particular importance the use of invasive devices and their management. Objectives: Aim of the study was to show correlations between possible risk factors and the occurrence of HAIs in the ICU of S.M. Goretti Hospital, Latina, Italy. Methods: Total number of patients hospitalized in the ICU during the study period (June 2008-June 2009) was 205. Analysis of medical records was conducted using a form prepared on the detection model for the surveillance of hospital infections (NNIS) and data were evaluated through a model of multiple logistic regression analysis. Results: Patients with a diagnosis of HAI were 30 (14.8%), 8% of isolates were multi-drug-resistant bugs. Following the CDC/NHSN criteria, it was possible to identify 13 patients (6.5%) with central venous catheter-related sepsis (BSI-CVC) and 26 patients (12.6%) with pneumonia associated with mechanical ventilation (VAP).Variables statistically significant for the development of nosocomial infections were: living in healthcare facilities (p = 0.008), presence of polytrauma (p = 0.04), surgical procedures (p = 0.003), cerebrospinal fluid derivation (p = 0.0001), presence of central venous catheter (p = 0.05), oro-tracheal intubation (p = 0.001), presence of nasogastric tube (p = 0.001) and parenteral nutrition (p = 0.0005). Conclusions: In our ICU the presence of nasogastric tube has emerged in multivariate analysis as a new independent risk factor for HAIs, especially VAP : p = 0.0008, OR (95% CI) 32.31.