Healthcare-associated infections in a rehabilitation hospital in Türkiye: A six-year retrospective analysis of incidence, pathogens and risk factors Türkiye’de bir rehabilitasyon hastanesinde sağlık hizmeti ilişkili enfeksiyonlar: İnsidans, patojenler ve risk faktörlerinin altı yıllık retrospektif analizi
Turk Hijyen ve Deneysel Biyoloji Dergisi, cilt.82, sa.4, ss.607-620, 2025 (Scopus, TRDizin)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 82 Sayı: 4
- Basım Tarihi: 2025
- Doi Numarası: 10.5505/turkhijyen.2025.37539
- Dergi Adı: Turk Hijyen ve Deneysel Biyoloji Dergisi
- Derginin Tarandığı İndeksler: Scopus, TR DİZİN (ULAKBİM)
- Sayfa Sayıları: ss.607-620
- Anahtar Kelimeler: Healthcare-associated infections, infection control, multidrug resistance, rehabilitation hospital, spinal cord injury, urinary tract infection
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Objective: This study aimed to evaluate the incidence, risk factors, causative microorganisms, and antibiotic resistance patterns of healthcare-associated infections (HAIs) over a six-year period in a tertiary physical medicine and rehabilitation hospital. Methods: In this retrospective study, the medical records of 9,139 patients hospitalized between January 1, 2017, and December 31, 2022, in a 210-bed tertiary physical medicine and rehabilitation hospital were reviewed. HAIs were defined according to the National Healthcare-Associated Infections Surveillance Diagnostic Guideline of the Directorate General of Public Health, Ministry of Health of the Republic of Türkiye. Results: During the study period, 179 patients developed HAIs. The incidence of HAIs was 1.95, and the incidence density was 0.56. The majority of patients were male (82.7%), with a median age of 40 years. The most common diagnoses were spinal cord injury (62%) and stroke/traumatic brain injury (15.2%). Of the HAIs, 92.2% were urinary tract infections (UTIs) and 7.8% were skin and soft tissue infections. The most frequently isolated microorganism was Escherichia coli (E. coli) (52.5%). Multidrug-resistant organisms accounted for 27.9% of isolates. Over the six-year period, a decreasing trend in HAI incidence density was observed; the incidence density of catheter-associated UTIs decreased by 67%, while the standardized infection ratio (SIR) declined from 1.6 in 2017 to 0.6 in 2022. This reduction was associated with infection control measures such as regular staff training, improved compliance with hand hygiene, implementation of national infection prevention bundles, antimicrobial stewardship, daily catheter assessments, and timely removal of unnecessary catheters. Conclusion: HAIs are common in physical medicine and rehabilitation centers, and this is particularly pronounced among patients with neurological disorders. The most frequent type of infection is UTI, with urinary catheter use being the main modifiable risk factor. E. coli was the most frequently isolated pathogen, and multidrug resistance remains a major concern. The decline in infection rates underscores the importance of infection control measures that are implemented effectively and continuously in rehabilitation hospitals.