Incidence and risk factors associated with healthcare associated infection of intensive care unit inpatients at Dr. Cipto Mangunkusumo Hospital

Background: The incidence of Healthcare Associated Infection (HAI) in the ICU is five to seven times higher compared to general. The aim of this study was to determine the incidence and risk factors for HAI in the ICU at Dr. Cipto Mangunkusumo hospital. Methods: This study use retrospective data, adult patients age ≥ 18 years who were treated in ICU and suspected diagnosis of HAI (including Ventilator associated pneumonia, Catheter associated urinary tract infection, Central line associated bloodstream infection and Surgical site infection) in period from October 2022 – January 2023 were included in this study. We analyze the examination results of each specimen with identification, antibiotic susceptibility test and genomic data using whole genome sequencing. Results: There were 160 specimens with 108 positive culture results. The organisms that most commonly cause infections from blood specimens are Klebsiella pneumoniae (3/11), Acinetobacter baumannii (1/11) and Pseudomonas aeruginosa (1/11). For sputum, the causative pathogens obtained included K. pneumoniae (23/57), A. baumannii (11/57), and P. aeruginosa (9/57). Meanwhile, for urine specimen the main bacteria causing infection was K. pneumoniae (4/7). In the antibiotic susceptibility test, the results showed Carbapenem Resistant Organisms (CRO), namely A. baumannii 89.5% (17/19), K. pneumoniae 76.3% (29/38), P. aeruginosa 40% (4/10), and E. coli 20% (1/5) with positive ESBL presentation are 15,8% in K. pneumoniae and 40% in E. coli . Conclusion: We found that the most common risk factor for HAI was the use of medical devices. Most of HAI infections that occurred in all specimens we took were caused by Klebsiella pneumoniae . Antibiotic resistance results show that many organisms that cause HAI are also resistant to Carbapenem antibiotics with variations in resistance genes (gene CTX-M, CTX-M-1, SHV, or TEM).