Epidemiology of intensive care unit (ICU)-acquired infections in a 14-month prospective cohort study in a single mixed Scandinavian university hospital ICU

Authors: Ylipalosaari; Ala-Kokko1; Laurila1; Ohtonen2; Syrjälä3

Source: Acta Anaesthesiologica Scandinavica, Volume 50, Number 10, November 2006 , pp. 1192-1197(6)

Publisher: Wiley-Blackwell

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Abstract:

Background: 

Our aim was to evaluate the epidemiology of intensive care unit (ICU)-acquired infections in a prospective cohort study. Methods: 

Patients with longer than a 48-h stay in an adult mixed medical–surgical ICU in a tertiary level teaching hospital were included. The incidence (per cent) and incidence density (per 1000 patient days) of ICU-acquired infections and the device-associated infection rates per 1000 device days were analysed prospectively in a 14-month study. Results: 

Eighty (23.9%) of 335 patients, whose ICU stay was longer than 48 h, acquired a total of 107 infections (1.3 per patient) during their ICU stay, with an infection rate of 48 per 1000 patient days. The most common infections were ventilator-associated pneumonia (VAP) [33.8% (18.8 per 1000 respiratory days)], other lower respiratory tract infections (LRTIs) (20%) and sinusitis (13.8%). The rate of central catheter-related (CRI) or primary bloodstream infections was 6.3% (2.2 per 1000 central venous catheter days), and the rate of urinary tract infections was 1.3% (0.5 per 1000 urinary catheter days). The first ICU infection was observed in 58.8% (47/80) of cases within 6 days after admission. The median time from admission to the diagnosis of an ICU-acquired infection was 4 days (25th–75th percentiles, 4.0–6.0) for VAP, 6.0 days (4.5–7.0) for LRTIs and 9.5 days (6.5–13.0) for CRIs. Conclusions: 

The rates of urinary tract infections and bloodstream infections were lower than reported previously, differentiating our results from the classic pattern of ICU-acquired infections, with the exception of the predominance of VAP.

Keywords: catheter-related bloodstream infection; cross-infection; incidence; intensive care; urinary tract infection; ventilator-associated pneumonia

Document Type: Research Article

DOI: http://dx.doi.org/10.1111/j.1399-6576.2006.01135.x

Affiliations: 1: Department of Anaesthesiology, Division of Intensive Care 2: Departments of Anaesthesiology and Surgery, Oulu University Hospital, Oulu, Finland 3: Department of Infection Control

Publication date: November 1, 2006

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