[Infections in the intensive care unit in reykjavik city hospital.]

To identify infection rates, sites, pathogens, modes of acquisition and outcome in the Intensive Care Unit (ICU) of Borgarspitalinn.

Two hundred patients admitted longer than 24 hours were studied prospectively. Definitions of infections were based on criteria from the Centers of Disease Control.

Seventy eight patients (39%) had a total of 128 infections. Sixty one percent were ICU acquired, 19% community acquired and 23% were other nosocomial infections. Thus, 24% of the patients developed an ICU acquired infection. The most common infections were pneumonia 30%, urinary tract infection 30%, septicemia 7% and intraabdominal infections 7%. The most common organisms isolated were S. epidermidis, E. coli, enterococci, S. aureus, S. pneumoniae, H. influenzae and P. aeruginosa. Infected patients stayed significantly longer in the unit, 7.9 days, but non- infected patients stayed 2.9 days. Infections were not related to age or gender, but were significantly associated with tracheal intubation, central lines, treatment with H2-blockers, and underlying heart- or lung disease. ICU mortality for infected patients was 13%, for non-infected patients 7% (p=ns), but 81% and 91% of infected and non-infected patients, respectively, survived to hospital discharge (p<0.05).

Nearly 40% of the ICU patients had an infection in the unit, 24% of the patients with ICU acquired infections. The need for continuing specific and accurate control and prevention of infections in the ICU setting is clear.