ИСТИНА

Nosocomial Infections in Neurocritical Care Authors D. Sergeev, L. Legostaeva, E. Mochalova, P. Prokazova, J. Ryabinkina, M. Piradov; Research Center of Neurology, Intensive Care Unit, Moscow/Russian Federation  Title Nosocomlal infections in neurocritical care  Background and aims Nosocomial infections (NI) may impact the outcome of neurological disorders requiring intensive care. Methods We perform longitudinal survey of NI in the neurocritical care department. Results Data on 100 patients was obtained from 2012 till 2016: 56% with stroke, 43% with Guillain-Barre syndrome (GBS) and myasthenia and 1 patient with ADEM and progressive encephalopathy each. The incidence of NI was 58%; 51% patients developed pneumonia, 28% - urinary tract infections (UTI), 16% - bloodstream infections and 13% - sinusitis. Only one type of infection (mostly pneumonia) was seen in 26% patients, while combination of NI was more often (29%; 5% patients suffered from all four NI types). Risk factors for NI was male sex and invasive manipulations (e.g., UTI was almost always associated with catheterization, and sinusitis in 100% cases was related to tracheal tube). Pneumonia was most frequent complication in ischemic stroke patients (69%) and was rarely seen in GBS (38%). Ventilator-associated pneumonia was seen in 50% patients who required respiratory support. The burden of NI was related to increased length of stay in neurocritical care department (median 9.5 days in patients without NI and 34.0 days in NI; p<0.001) and duration of mechanical ventilation (5.5 days vs 23.0 days, respectively; p=0.001). While no impact of NI on mortality rate was seen (10% vs 14%, respectively; p=0.517), among patients who suffered from all four types of NI mortality rate was 40%. Conclusion Special efforts are needed to prevent and successfully treat NI in neurocritical care setting.