Background: The rate 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 a total of 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 specimens, 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 suscpetibility 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. HAI infections that occurred from all the specimens we took were mainly caused by Klebsiella pneumoniae. The results of antibiotic resistance are also a matter of note because there are many organism that cause HAI were also Carbapenem-resistant antibiotics with variations in resistance genes (CTX-M, CTX-M-1, SHV, TEM).

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).

Introduction: In the Intensive Care Unit(ICU), healthcare-associated infections can arise from factors such as compromised patient immunity and the use of diverse medical equipment. Furthermore, inadequate awareness of infection control among ICU staff can further increase the risk of infections. Therefore, it is crucial for ICU staff to recognize and address infection risks proactively. To enhance infection control measures, designated infection control facilitators within the department have spearheaded infection control activities. Case Presentation: Internal assessments within the ICU identified areas requiring improvement in infection control, leading to the formulation of a self-improvement initiative. The evaluation results revealed deficiencies in pre- hub disinfection and the appropriateness of Chlorhexidine gluconate(CHG) bathing. To address this, ICU team members were tasked with monitoring hand hygiene and performing pre-hub disinfection at least 10 times before central venous catheter usage. The monitoring results were shared with department members monthly, encouraging performance improvement by rewarding outstanding employees. Additionally, protocols and educational videos for proper CHG bathing were developed within the ICU and reviewed by the Infection Control Department. Using this material, internal education sessions were conducted within the ICU to support all team members in achieving their goals. Discussion: Through various improvement initiatives, staff awareness of infection control has increased, leading to proper CHG bathing and hub disinfection. The incidence rate of central venous catheter-related bloodstream infections decreased from 4.25 in 2022 to 3.35 in 2023. Additionally, hand hygiene compliance increased from 92% in 2022 to 96% in 2023. For effective infection management, the participation of not only the Infection Control Department but also departmental members is crucial. Through effective collaboration and discussions between ICU staff and the infection control team, we were able to address departmental issues, improve staff awareness and performance in infection management. Sustained interest and participation in these activities require continuous staffing and support.