One-year epidemiological analysis of nosocomial infections and antimicrobial resistance in a Hungarian intensive care unit.

BACKGROUND

Healthcare-associated infections (HAIs) acquired in intensive care units (ICUs) represent a major burden of morbidity and mortality worldwide. However, national data in Hungary are limited, and few studies compare local findings with national and international surveillance systems.

METHODS

We conducted a retrospective longitudinal study involving 1002 patients admitted to ICUs between 1st May 2023 and 30th April 2024. We analysed the prevalence, types and distribution of pathogens responsible for HAIs. Data were compared with national reports from the Hungarian National Nosocomial Surveillance System and international reports from the Centers for Disease Control and Prevention and European Centre for Disease Prevention and Control.

RESULTS

The overall prevalence of HAIs was 16.9% (169/1002 patients). The most frequent infection types were lower respiratory tract infections (9.2%), ventilator-associated pneumonia (4.3%), urinary tract infections (UTIs, 3.8%) and Clostridioides difficile infections (2.5%). All UTIs identified during the study period were catheter-associated urinary tract infection, attributable to the high device utilisation rate in the ICU, where all patients had an indwelling urinary catheter during their stay. The leading pathogens were Pseudomonas aeruginosa (23.7%), Clostridioides difficile (13.0%), Klebsiella pneumoniae (13.0%), Enterococcus faecalis (11.6%) and Escherichia coli (5.8%). Overall, 30.9% (64/207) of isolates were multi-drug resistant (MDR).

CONCLUSION

Our study highlighted the considerable prevalence of HAIs and the dominance of MDR Gram-negative bacteria. Comparison with international data helps identify areas requiring targeted infection control measures.