Mortality among Patients with Nosocomial Infections in Tertiary Intensive Care Units of Sahloul Hospital, Sousse, Tunisia

BACKGROUND: Nosocomial infections are public health issues that are associated with high mortality in intensive care units. This study aimed to determine nosocomial infection-associated mortality in Tunisian intensive care units and identify its risk factors. METHODS: A prospective cohort study was carried out in intensive care units of a Tunisian University Hospital. The ICUs-wide active surveillance of nosocomial infections has been performed between 1 July 2010 and 30 June 2011. Data collection was based on Rea-Raisin protocol 2009 of "Institut National de Veille Sanitaire" (InVS, Saint Maurice - France). We used Kaplan Meier survival analysis and Cox Proportional Hazard regression to identify independent risk factors of nosocomial infection-associated mortality. RESULTS: Sixty-seven patients presented nosocomial infection in the end of the surveillance. The mean age of patients was 44.71 ± 21.2 years. Of them, 67.2% were male and 32.8% female. Nosocomial bacteremia was the most frequent infection (68.6%). Nosocomial infection-associated mortality rate was 35.8% (24/67). Bacteremia (Hazard Ratio (HR)) = 3.03, 95% Confidential Interval (95% CI): [1.23 – 7.45], P=0.016) and trauma (HR = 3.6, 95% CI: [1.16 – 11.2], P = 0.026) were identified by Cox regression as independent risk factors for NI-associated mortality. CONCLUSIONS: Our rate was relatively high. We need to improve the care of trauma patients and intensify the fight against nosocomial infections especially bacteremia.