title: [Microbiological isolates associated with nosocomial infections in intensive care units: data of 274 intensive care units participating in the German Nosocomial Infections Surveillance System (KISS)].
abstract: OBJECTIVE
  To describe the frequency and distribution of microbiological isolates in association with nosocomial infections (NI) in intensive care units (ICUs) in Germany.
  
  
  METHODS
  The hospital infection surveillance system (KISS = Krankenhaus-Infektions-Surveillance-System) started in Germany in January 1997 as a nationwide surveillance project for the voluntary registration of nosocomial infections. For ICUs reporting focuses on device-associated primary bloodstream infections, urinary tract infections, as well as on pneumonia and bronchitis. The data collected for each patient who acquires a nosocomial infection include the site of infection and patient demographics. Up to 4 pathogens can be recorded for each infection.
  
  
  RESULTS
  From 1997 until 2002 274 ICUs were participating. The data of 590 695 patients with 18 073 device associated infections (ventilator-associated pneumonia and bronchitis, central line-associated bloodstream infection (BSI) and urinary catheter-associated urinary tract infection (UTI)) were analyzed. In the group of device-associated NI S. aureus was most frequently isolated (16.5/100NI) followed by Ps. aeruginosa (14.2/100NI), E. coli (13.9/100NI), enterococci (13.4/100NI) and C. albicans (11.2/100NI). Of all S. aureus isolates 20.0 % were MRSA. There was an increase of the MRSA rate from 8 % in 1997 to 26.9 % in 2002. The most frequent pathogen in BSI was coagulase-negative staphylococcus (31.0/100NI). In ventilator-associated pneumonia and bronchitis S. aureus was the most frequent pathogen (24.2 and 24.9/100NI). In more than half of all catheter-associated UTI E. coli (25.7/100NI) and enterococci (25.4/100NI) were found. After stratification for the type of ICU differences in the distribution of pathogens could be shown.
  
  
  CONCLUSIONS
  The KISS data give an overview of the most important pathogens associated with nosocomial infections on ICUs in Germany.
authors.affiliation: Nationales Referenzzentrum für Surveillance von nosokomialen Infektionen. christine.geffers@charite.de
authors.forename: C
authors.initials: C
authors.lastname: Geffers
authors.forename: I
authors.initials: I
authors.lastname: Zuschneid
authors.forename: D
authors.initials: D
authors.lastname: Sohr
authors.forename: H
authors.initials: H
authors.lastname: Rüden
authors.forename: P
authors.initials: P
authors.lastname: Gastmeier
mesh_terms: D003428:Cross Infection / Q000453:epidemiology* / Q000209:etiology / Q000382:microbiology*; D004864:Equipment and Supplies / Q000009:adverse effects; D005858:Germany / Q000453:epidemiology; D006801:Humans; D007362:Intensive Care Units; D016106:Methicillin Resistance; D011159:Population Surveillance; D013203:Staphylococcal Infections