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.