Epidemiology of intensive care unit (ICU)-acquired infections in a 14-month prospective cohort study in a single mixed Scandinavian university hospital ICU.
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.
Ylipalosaari
P
P
Department of Infection Control, Oulu University Hospital, Oulu, Finland. pekka.ylipalosaari@oulu.fi
Ala-Kokko
T I
TI
Laurila
J
J
Ohtonen
P
P
Syrjälä
H
H
D000328:Adult; D000368:Aged; D001424:Bacterial Infections / Q000145:classification / Q000453:epidemiology; D017714:Community-Acquired Infections / Q000145:classification / Q000453:epidemiology*; D003428:Cross Infection / Q000145:classification / Q000453:epidemiology*; D005260:Female; D005387:Finland; D006746:Hospital Bed Capacity, 500 and over / Q000706:statistics & numerical data; D006785:Hospitals, University; D006801:Humans; D007362:Intensive Care Units / Q000592:standards*; D008297:Male; D008875:Middle Aged; D018410:Pneumonia, Bacterial / Q000453:epidemiology