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[Epidemiology of infections at the intensive care unit]
Tomasz Siegel1, Małgorzata Mikaszewska-Sokolewicz, Ewa Mayzner-Zawadzka
1Akademia Medyczna w Warszawie, Katedra i I Zakład Anestezjologii i Intensywnej Terapii. tmsiegel@wp.pl
Objectives:
Infections at the Intensive Care Units (ICU) are a substantial clinical problem due to their high incidence and significant impact on patient mortality, as well as on the duration of their treatment within ICUs. The objective of the present study was to analyse the infections occurring at our department and to identify those micro-organisms responsible for infections, with consideration of their susceptibility to antibiotic treatment. Moreover, an evaluation was performed in respect of correlation between infection incidence, patient mortality and duration of stay at the department.
Material And Methods:
The study concerned all patients admitted to the ICU between February and July 2004, with a stay duration of > 24h. The occurring infections were divided into groups, depending on the first symptoms occurrence, of external infections (< 48h) and intra-department infections (> 48h). When diagnosing infection symptoms, the CDC definitions were applied.
Results:
78 patients were qualified to participate in the study, among which external infections were diagnosed in 73%, while infections at the department were diagnosed in 44.9%. The average APACHE II scale scoring in the first day of treatment was 20, higher in the case of external infections. The most commonly occurring infections were: pneumonia (33%), blood infections (17%), lower respiratory tract infections (15%) and urinary tract infections (12%). The most commonly cultured micro-organisms responsible for observed infections were: Candida sp., Enterococcus sp., Staphylococcus sp., Pseudomonas sp., Enterobacter sp. and Acinetobacter sp. Among studies patients, the death rate was 37%. High mortality correlated with old age, higher APACHE II scoring and presence of externally acquired infections. The average stay at the department was 10 days and was significantly longer than in patients with department infections.
Conclusions:
The distribution of infections and their etiological pathogens was similar to results obtained in studies performed in other developed countries. A correlation was evidenced between the occurrence of external, internal infections and, respectively, the increased mortality and length of hospitalisation of patients within ICUs.
Insights
Intensive Care Unit (ICU) infections are common and linked to higher mortality and longer hospital stays. Identifying causative microbes and their antibiotic susceptibility is crucial for patient outcomes.
Area of Science:
- Critical Care Medicine
- Infectious Diseases
- Hospital Epidemiology
Background:
- Intensive Care Unit (ICU) infections pose a significant clinical challenge, increasing patient mortality and treatment duration.
- Understanding the epidemiology of ICU infections and the responsible microorganisms is vital for effective management.
Purpose of the Study:
- To analyze infections within an ICU, identify causative microorganisms, and assess their antibiotic susceptibility.
- To evaluate the correlation between infection incidence, patient mortality, and length of ICU stay.
Main Methods:
- The study included patients admitted to the ICU between February and July 2004 with stays exceeding 24 hours.
- Infections were classified as external (onset <48h) or internal (onset >48h), using CDC definitions.
- APACHE II scores were recorded on admission to assess patient severity.
Main Results:
- External infections occurred in 73% of patients, and internal infections in 44.9%.
- Pneumonia (33%), bloodstream infections (17%), lower respiratory tract infections (15%), and urinary tract infections (12%) were most common.
- Candida sp., Enterococcus sp., and Staphylococcus sp. were frequently isolated pathogens. Mortality was 37%, correlating with age, APACHE II scores, and external infections.
Conclusions:
- ICU infection patterns and pathogens align with those reported in developed countries.
- A significant correlation exists between external/internal ICU infections and increased patient mortality and hospitalization duration.
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