By Eleni Apostolopoulou, RN, PhD, Vasilios Raftopoulos, RN, PhD, Georgios Filntisis, MD, PhD, Prokopis Kithreotis, MD, PhD, Evagelos Stefanidis, RN, PhD, Petros Galanis, RN, PhD, and Dimitrios Veldekis, MD, PhD Background Several studies suggest that device-associated, health care–associated infections (DA-HAIs) affect the quality of care in intensive care units, increasing patients’ morbidity and mortality and the costs of patient care. Objectives To assess the DA-HAIs rates, microbiological profile, antimicrobial resistance, and crude excess mortality in 3 intensive care units in Athens, Greece. Methods A prospective cohort, active DA-HAI surveillance study was conducted in 3 Greek intensive care units from July 2009 to June 2010. The rates of mechanical ventilator–associated pneu- monia (VAP), central catheter-associated bloodstream infection (CLABSI), and catheter-associated urinary tract infection (CAUTI) were calculated along with microbiological profile, antimicrobial resistance, and crude excess mortality. Results During 6004 days in intensive care, 152 of 294 patients acquired 205 DA-HAIs, an overall rate of 51.7% of patients or 34.1 DA-HAIs per 1000 days (95% CI, 29.3-38.6). The VAP rate was 20 (95% CI, 16.3-23.7) per 1000 ventilator-days, the CLABSI rate was 11.8 (95% CI: 9.2-14.8) per 1000 catheter-days, and the CAUTI rate was 4.2 (95% CI, 2.5-5.9) per 1000 catheter-days. The most frequently isolated pathogen was Acinetobacter bauman- nii among patients with CLABSI (37.8%) and Candida species among patients with CAUTI (66.7%). Excess mortality was 20.3% for VAP and CLABSI and 32.2% for carbapenem-resistant A bau- mannii CLABSI. Conclusion High rates of DA-HAIs, device utilization, and anti- microbial resistance emphasize the need for antimicrobial stew- ardship, the establishment of an active surveillance program of DA-HAIs, and the implementation of evidence-based preventive strategies. (American Journal of Critical Care. 2013;22:e12-e20) SURVEILLANCE OF DEVICE-ASSOCIATED INFECTION RATES AND MORTALITY IN 3 GREEK INTENSIVE CARE UNITS e12 AJCC AMERICAN JOURNAL OF CRITICAL CARE, May 2013, Volume 22, No. 3 www.ajcconline.org ©2013 American Association of Critical-Care Nurses doi: http://dx.doi.org/10.4037/ajcc2013324 Patient Safety Issues guest on April 201 ajcc.aacnjournals.org o nloaded from