title: Epidemiology of nosocomial infection in 125 Italian intensive care units.
abstract: OBJECTIVE
  A continuous infection surveillance program was conducted by GiViTI throughout 2006 in Intensive Care Units (ICUs).
  
  
  METHODS
  This was a prospective epidemiological study carried out in 125 Italian intensive care units. All patients have been included in the study. Aside from the detailed clinical information collected for all patients, in cases of infection upon ICU admission and for the first site-specific episode that occurred during the patient's stay, the following data were collected: severity upon admission, micro-organisms and their antibiotic resistance patterns, subsequent multiple episodes in the same site, origin of infections and maximum severity reached. The diagnostic criteria for all infections are explicitly stated.
  
  
  RESULTS
  A total of 34,472 patients entered the study. Infection upon admission was present in 12.6% of patients, with a high level of ICU and hospital mortality (29.4% and 38.7%, respectively). In 3148 patients one or more infections were reported as ICU-acquired with an overall incidence of 9.1% and an ICU and hospital mortality of 27.2% and 35.1%, respectively. Out of the device-related infections, ventilator-associated pneumonia was the most frequently diagnosed (8.9/1000 days on ventilator). Catheter-related blood stream infection was reported with a low incidence (1.9/1000 central venous catheter days). Nearly 20% of more than 5000 isolated microorganisms were classified as multi-drug resistant, with methicillin-resistant Staphylococcus aureus as the most frequently reported bug.
  
  
  CONCLUSIONS
  The ad hoc expanded GiViTI software "Margherita2" allows continuous infection surveillance in Italian ICUs, annually providing an extensive and updated database. Interventions to improve infection prevention and patient safety should be tailored to accommodate these data.
authors.affiliation: Department of Anesthesiology, Resuscitation and Emergency, S. Chiara Hospital, Pisa, Italy. pmalacarne@hotmail.com
authors.forename: P
authors.initials: P
authors.lastname: Malacarne
authors.forename: D
authors.initials: D
authors.lastname: Boccalatte
authors.forename: A
authors.initials: A
authors.lastname: Acquarolo
authors.forename: F
authors.initials: F
authors.lastname: Agostini
authors.forename: A
authors.initials: A
authors.lastname: Anghileri
authors.forename: M
authors.initials: M
authors.lastname: Giardino
authors.forename: D
authors.initials: D
authors.lastname: Giudici
authors.forename: M
authors.initials: M
authors.lastname: Langer
authors.forename: S
authors.initials: S
authors.lastname: Livigni
authors.forename: E
authors.initials: E
authors.lastname: Nascimben
authors.forename: C
authors.initials: C
authors.lastname: Rossi
authors.forename: G
authors.initials: G
authors.lastname: Bertolini
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003428:Cross Infection / Q000453:epidemiology*; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D007558:Italy; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance; D011446:Prospective Studies; D055815:Young Adult