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[Frequency of infections in intensive care units: an incidence survey]
J Godard1, C Vedrinne, J Motin
1Service de réanimation, Hôpital Edouard Herriot, Lyon.
Abstract:
During a nine months period, 568 patients entered the Polyvalent Intensive Care Unit and were prospectively studied: 153 became infected and 289 infections were diagnosed. Urinary tract infections (31%) in patients with indwelling catheter, lower respiratory tract infections (22%) in tracheally intubated and ventilated patients and bacteremias (19%) totalized 75% of all I.C.U. acquired infections. Post operative and trauma patients were more frequently infected than medical patients. E. coli (19%), S. aureus (14%), Enterococcus (13%) and P. aeruginosa (12%) were isolated and resistance to antibiotics was not always important. The prescribed treatment was an association of antibiotics in 55% of cases. The group whose patients were infected had a longer stay in I.C.U. and a higher mortality rate than group of uninfected patients.
Insights
Intensive care unit (ICU) infections are common, particularly urinary tract and respiratory infections. These hospital-acquired infections increase patient mortality and length of stay.
Area of Science:
- Infectious Diseases
- Critical Care Medicine
- Hospital Epidemiology
Background:
- Hospital-acquired infections (HAIs) are a significant concern in intensive care units (ICUs).
- Understanding the epidemiology of ICU-acquired infections is crucial for developing effective prevention and control strategies.
- Previous studies have highlighted the burden of HAIs, but specific data from polyvalent ICUs can inform targeted interventions.
Purpose of the Study:
- To prospectively investigate the incidence, types, and causative agents of infections acquired in a polyvalent intensive care unit (ICU).
- To identify patient populations at higher risk for ICU-acquired infections.
- To analyze the impact of these infections on patient outcomes, including length of stay and mortality.
Main Methods:
- Prospective study of 568 patients admitted to a polyvalent ICU over a nine-month period.
- Detailed recording of diagnosed infections, including type, site, and identified microorganisms.
- Analysis of patient demographics, underlying conditions, and treatment regimens, including antibiotic use.
Main Results:
- 153 out of 568 patients (27%) acquired infections during their ICU stay, with 289 infections diagnosed overall.
- The most frequent infections were urinary tract infections (31%), lower respiratory tract infections (22%), and bacteremias (19%), accounting for 75% of all ICU-acquired infections.
- Postoperative and trauma patients had higher infection rates than medical patients. Common pathogens included E. coli, S. aureus, Enterococcus, and P. aeruginosa.
Conclusions:
- ICU-acquired infections significantly increase both the length of stay and mortality rates among critically ill patients.
- Urinary tract infections and lower respiratory tract infections are the predominant HAIs in this polyvalent ICU setting.
- Targeted surveillance and infection control measures, especially for catheterized and ventilated patients, are essential to mitigate the burden of HAIs.