[Epidemiology of infections at the intensive care unit].
OBJECTIVE
Infections at the Intensive Care Units (ICU) are a substantial clinical problem due to their high incidence and significant impact on patient mortality, as well as on the duration of their treatment within ICUs. The objective of the present study was to analyse the infections occurring at our department and to identify those micro-organisms responsible for infections, with consideration of their susceptibility to antibiotic treatment. Moreover, an evaluation was performed in respect of correlation between infection incidence, patient mortality and duration of stay at the department.


METHODS
The study concerned all patients admitted to the ICU between February and July 2004, with a stay duration of > 24h. The occurring infections were divided into groups, depending on the first symptoms occurrence, of external infections (< 48h) and intra-department infections (> 48h). When diagnosing infection symptoms, the CDC definitions were applied.


RESULTS
78 patients were qualified to participate in the study, among which external infections were diagnosed in 73%, while infections at the department were diagnosed in 44.9%. The average APACHE II scale scoring in the first day of treatment was 20, higher in the case of external infections. The most commonly occurring infections were: pneumonia (33%), blood infections (17%), lower respiratory tract infections (15%) and urinary tract infections (12%). The most commonly cultured micro-organisms responsible for observed infections were: Candida sp., Enterococcus sp., Staphylococcus sp., Pseudomonas sp., Enterobacter sp. and Acinetobacter sp. Among studies patients, the death rate was 37%. High mortality correlated with old age, higher APACHE II scoring and presence of externally acquired infections. The average stay at the department was 10 days and was significantly longer than in patients with department infections.


CONCLUSIONS
The distribution of infections and their etiological pathogens was similar to results obtained in studies performed in other developed countries. A correlation was evidenced between the occurrence of external, internal infections and, respectively, the increased mortality and length of hospitalisation of patients within ICUs.
Siegel
Tomasz
T
Akademia Medyczna w Warszawie, Katedra i I Zakład Anestezjologii i Intensywnej Terapii. tmsiegel@wp.pl
Mikaszewska-Sokolewicz
Małgorzata
M
Mayzner-Zawadzka
Ewa
E
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001424:Bacterial Infections / Q000453:epidemiology* / Q000382:microbiology / Q000401:mortality; D002648:Child; D003428:Cross Infection / Q000453:epidemiology* / Q000382:microbiology / Q000401:mortality; D005260:Female; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data*; D007902:Length of Stay / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D009181:Mycoses / Q000453:epidemiology* / Q000382:microbiology / Q000401:mortality; D011044:Poland / Q000453:epidemiology; D011446:Prospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index