[Dutch results of the European study of prevalence of infection during intensive care (EPIIC). II. Nature of the infections].
OBJECTIVE
Evaluation of the point prevalence of ICU-acquired infections, the type of infection, the bacteriological cultures and the antibiotics used.


METHODS
Point prevalence study.


METHODS
78 Dutch ICUs, as part of ICUs in 17 West-European countries.


METHODS
Collecting data by detailed questionnaires for each patient admitted to one of the participating ICUs, on one specified day: April 29th, 1992. Follow-up lasted 6 weeks.


RESULTS
The most frequently diagnosed ICU-acquired infections were pneumonia and infections of the lower respiratory tract (together 63%), followed by urinary tract infections (16%), sepsis (16%) and wound infections (11%). The most frequently cultured pathogens were Gram-negative bacteria (92%), especially Enterobacteriaceae (34%) and Pseudomonas aeruginosa (30%), followed by Staphylococcus (37%), Enterococcus (20%) and surprisingly: 10% fungi. The most-prescribed antibiotics were the cephalosporins (30%), followed by broad-spectrum penicillins (17%), metronidazole (17%) and aminoglycosides (13%). On the day of this survey there was in the Netherlands no infection with MRSA (Methicillin Resistant Staphylococcus aureus), although gentamicin resistant coagulase-negative Staphylococcus and ciprofloxacin-resistant P. aeruginosa were present. In most of the hospitals in the Netherlands, microbiologists, infectious disease specialists (84%) and infection control nurses (51%) take part in the ICU team. Half of the hospitals use selective decontamination.


CONCLUSIONS
ICU-acquired infections are a real threat to the ICU patient. Despite a cautious antibiotics management in the Netherlands, resistance remains a serious problem.
Ibelings
M S
MS
Ikazia Ziekenhuis, afd. Heelkunde, Rotterdam.
Bruining
H A
HA
D000293:Adolescent; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D002648:Child; D005260:Female; D006090:Gram-Negative Bacteria / Q000302:isolation & purification*; D006801:Humans; D007239:Infections / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology*; D008297:Male; D008875:Middle Aged; D009181:Mycoses / Q000382:microbiology; D009426:Netherlands / Q000453:epidemiology; D015995:Prevalence; D012141:Respiratory Tract Infections / Q000382:microbiology; D012307:Risk Factors; D018805:Sepsis / Q000382:microbiology; D014552:Urinary Tract Infections / Q000382:microbiology; D014946:Wound Infection / Q000382:microbiology
D000900:Anti-Bacterial Agents
Nederlandse resultaten van het Europese prevalentieonderzoek naar infecties tijdens intensive care (EPIIC). II. Aard van de infecties.