Zasady prenumeraty miesięcznika Wiadomości Lekarskie na rok 2019 Zamówienia na prenumeratę przyjmuje Wydawnictwo Aluna

DISCUSSION
This report presents the first surveillance data across all 
HAI types in ICUs from Ukraine. Surveillance for surgical 
site infections was not performed in this study.
HAI surveillance data are crucial for informing priorities 
for infection control. The surveillance data described in this 
report identify several priority areas for prevention. First, 
PNEU, primary BSIs, and UTIs represented over 80% of HAIs 
reported and should be the focus for infection prevention 
(e.g., prevention of device-associated infections [14]) and 
continued surveillance efforts. The highest CLABSI rate 
was reported from NICUs, indicating an important target 
for CLABSI prevention. Second, gram-negative organisms 
were commonly associated with HAIs, and high rates of 
antimicrobial resistance were present in participating ICUs.
The cumulative incidence of HAIs in ICU wards varies 
widely among countries (5%–38.9%) [15], and the detected 
rate in the present surveillance (9.2%) was in the range 
of values specified in other studies. Data reported by The 
European Surveillance System showed that, in 2014, 8% 
of the patients staying in the ICU for more than 2 days 
presented at least one HAI [16]. The HAI incidence rate of 
9.1 per 1000 patient days was less than that noticed in the 
study from the USA where the rate of HAI in an adult ICU 
was shown to be 16.2 per 1000 patient days [17].
PNEU was the most commonly identified HAI in this 
surveillance system. The majority of HAIs in ICUs are 
associated with the use of invasive devices. Therefore, 
our surveillance system paid particular attention to DAIs, 
since a significant proportion of these HAIs are considered 
preventable. The findings showed that the most common 
DAI was VAP (46.8%), consistent with the reported 
literature. Globally, the VAP rate we observed (18.2/1000 
MV days) was higher than the surveillance data from 
Germany (5.4/1000 MV days) [18] and from the United 
States where the VAP incidence rate was 2.1 per 1000 device 
days in medical/surgical major teaching ICUs [19].
The CLABSI incidence rate (8.2 per 1000 CL days) we 
observed was much lower than that reported from limited-
resource countries [20], but higher than 1.1 per 1000 CL 
days reported in the medical/surgical major teaching ICUs 
in the healthcare facilities adhering to NHSN surveillance 
[19]. In the SPIN-UTI, in the 2010–2011 survey, and in the 
GiViTi projects the CLABSI incidence rate was 1.8 and 
1.9 per 1000 CVC days, respectively [21]. The higher rate 
in the present surveillance could be explained by a high 
CL utilization ratio, exceeding the 90th percentile of the 
NHSN distribution for medical/surgical major teaching 
ICUs. Intravascular devices remain an essential component 
of ICU care, but many studies recognize CL duration as a 
risk factor for CLABSI [22]. 
The reasons for lower CAUTI rates observed in the 
present study compared with other studies may be related 
to the effectiveness of the interventions implemented in 
our setting. They included educational strategies, UC 
avoidance, policies for UC insertion, daily necessity 
review and limiting catheter days that have been proven