Device-associated hospital-acquired infections in a tertiary cardiac hospital in northern Iran: A six-year retrospective study

Arshia Forouzan; Seyed Mehdi Mousavi; Tofigh Yaghubi Kalurazi; Meysam Hasannejad-Bibalan; Fatemeh Kheradkish; Avasadat Hosseini

doi:10.66224/jcbior.7.2.353

Authors

Arshia Forouzan Razi Clinical Research Development Unit, Razi Hospital, Guilan University of Medical Sciences, Rasht, Iran
Seyed Mehdi Mousavi Razi Clinical Research Development Unit, Razi Hospital, Guilan University of Medical Sciences, Rasht, Iran
Tofigh Yaghubi Kalurazi Razi Clinical Research Development Unit, Razi Hospital, Guilan University of Medical Science, Rasht, Iran https://orcid.org/0000-0002-6042-2331
Meysam Hasannejad-Bibalan Department of Microbiology, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran https://orcid.org/0000-0002-9402-098X
Fatemeh Kheradkish Shahid Beheshti Hospital, Guilan University of Medical Sciences, Anzali, Iran
Avasadat Hosseini Razi Clinical Research Development Unit, Razi Hospital, Guilan University of Medical Sciences, Rasht, Iran

DOI:

https://doi.org/10.66224/jcbior.7.2.353

Keywords:

Device-associated infection, Healthcare-associated infection, Catheter-related infection, Cardiac hospital

Abstract

Device-associated healthcare-associated infections (DA-HAIs) remain a major challenge in hospitalized patients, particularly among those requiring invasive medical devices. This study aimed to describe the epidemiological characteristics, distribution of causative microorganisms, and clinical outcomes of DA-HAIs in a tertiary cardiac hospital in northern Iran. In this retrospective descriptive study, hospital records and infection surveillance data of patients with DA-HAIs were reviewed from March 21, 2018, to March 21, 2024. Eligible cases included hospitalized patients with documented exposure to invasive devices, including urinary catheters, vascular devices, or mechanical ventilation. Demographic characteristics, hospitalization-related variables, device-associated infection types, microbiological findings, and in-hospital outcomes were collected using a structured data extraction. A total of 320 episodes of DA-HAIs were identified. The median age of affected patients was 67 years (IQR: 59–75), and 67.5% were female. Catheter-associated urinary tract infection (CAUTI) was the most frequent infection type, accounting for 88.1% of cases, followed by ventilator-associated events/pneumonia (9.1%), peripheral intravenous catheter-associated bloodstream infections (1.9%), and central line-associated bloodstream infections (0.9%). Escherichia coli was the predominant microorganism, responsible for 57.5% of all isolates, with Gram-negative bacteria representing the majority of identified pathogens. Overall, 42 patients (13.1%) died during hospitalization. This study demonstrates a substantial burden of DA-HAIs in a tertiary cardiac hospital, characterized by a predominance of CAUTI and Gram-negative bacterial pathogens. Continuous device-associated infection surveillance, optimization of device utilization, and targeted infection prevention strategies are essential to reduce the clinical impact of these infections in specialized cardiac care settings.

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