Building a continuous multicenter infection surveillance system in the intensive care unit: findings from the initial data set of 9,493 patients from 71 Italian intensive care units

Autor: MALACARNE P, LANGER M, NASCIMBEN E, MORO ML, GIUDICI D, LAMPATI L, BERTOLINI G, ITALIAN GROUP FOR THE EVALUATION OF INTERVENTIONS IN INTENSIVE CARE MEDICINE, GIARRATANO, Antonino
Přispěvatelé: Malacarne, P., Langer, M., Nascimben, E., Moro, Ml, Giudici, D, Lampati, L, Bertolini, G, Italian Group for the Evaluation of Interventions in Intensive Care, Medicine, Ferraro, Fausto, MALACARNE P, LANGER M, NASCIMBEN E, MORO ML, GIUDICI D, LAMPATI L, BERTOLINI G, GIARRATANO A, ITALIAN GROUP FOR THE EVALUATION OF INTERVENTIONS IN INTENSIVE CARE MEDICINE
Rok vydání: 2008
Předmět:
Resuscitation
medicine.medical_specialty
Medical Records Systems
Computerized
Quality Assurance
Health Care
health care facilities
manpower
and services
critically ill
Critical Care and Intensive Care Medicine
Infections
law.invention
critical care medicine sepsis infectious disease
law
Risk Factors
Intensive care
Epidemiology
medicine
Infection control
Humans
Hospital Mortality
Prospective Studies
Intensive care medicine
Infection surveillance
business.industry
Septic shock
Incidence
Length of Stay
Middle Aged
medicine.disease
Prognosis
Intensive care unit
infection control
infection
Icu admission
severe sepsis
Survival Rate
Intensive Care Units
infection control control
Logistic Models
Italy
Population Surveillance
septic shock
business
intensive care units
critically ill
infection
infection control
severe sepsis
septic shock
Zdroj: Critical care medicine. 36(4)
ISSN: 1530-0293
Popis: OBJECTIVE: To describe the epidemiology of infections in intensive care units (ICUs), whether present at admission or acquired during the stay. METHODS: Prospective data collection lasting 6 months in 71 Italian adult ICUs. Patients were screened for infections and risk factors at ICU admission and daily during their stay. MAIN RESULTS: Out of 9,493 consecutive patients admitted to the 71 ICUs, 11.6% had a community-acquired infection, 7.4% a hospital-acquired infection, and 11.4% an ICU-acquired infection. The risk curve of acquiring infection in the ICU was higher in patients who entered without infection than in those already infected (log-rank test, p < .0001; at 15 days, 44.0% vs. 34.6%). Hospital mortality (27.8% overall) was higher in patients admitted with infection than in those who acquired infection in the ICU (45.0% vs. 32.4%, p < .0001). Although the presence of infection per se did not influence mortality, the conditions of severe sepsis and septic shock were strong prognostic factors (odds ratio, 2.3 and 4.8, respectively). Apart from ICU-acquired peritonitis, no other site of infection reached statistical significance as an independent prognostic factor for hospital mortality. CONCLUSIONS: Adding specific data on infections and risk factors to a well-established electronic data collection system is a reliable basis for a continuous multicenter infection surveillance program in the ICU. Given the well-established importance of infection prevention programs, our data suggest that the improvement of the treatment of severe sepsis and septic shock is the key to lower infection-related mortality in the ICU. This calls for closer attention to severe infections in surveillance programs. intensive care units; critically ill; infection; infection control; severe sepsis; septic shock.
Databáze: OpenAIRE
Externí odkaz: