Intensive Care Medicine

, Volume 24, Issue 10, pp 1040–1046

Nosocomial infections: prospective survey of incidence in five French intensive care units

Authors

  • A. Legras
    • Service de Réanimation Médicale, Hôpital Bretonneau, F-37 044 Tours cedex 1, France Tel.: + 33(2)47473855 Fax: + 33(2)47396536
  • D. Malvy
    • Department of Hospital Hygiene and Epidemiology, CHU Bretonneau, F-37 044 Tours cedex 1, France
  • A. I. Quinioux
    • Department of Hospital Hygiene and Epidemiology, CHU Bretonneau, F-37 044 Tours cedex 1, France
  • D. Villers
    • Intensive Care Unit, University Hospital Nantes, France
  • G. Bouachour
    • Intensive Care Unit, University Hospital Angers, France
  • R. Robert
    • Intensive Care Unit, University Hospital Poitiers, France
  • R. Thomas
    • Intensive Care Unit, University Hospital Rennes, France
ORIGINAL

DOI: 10.1007/s001340050713

Cite this article as:
Legras, A., Malvy, D., Quinioux, A. et al. Intensive Care Med (1998) 24: 1040. doi:10.1007/s001340050713

Abstract

Objective: To assess the incidence and to evaluate the feasibility of inter-unit continuous surveillance of intensive care unit (ICU)-acquired infections. Design: Prospective multicentre, longitudinal, incidence survey. Setting: Five ICUs in university hospitals in western France. Patients: All patients admitted to the ICU during two 3-month periods (1994–1995). Measurements and results: The main clinical characteristics of the patients, ICU-acquired infections, length of exposure to invasive devices and the micro-organisms isolated were analysed. The study included 1589 patients (16 970 patient-days) and the infection rate was 21.6 % (13.1 % of patients). The ventilator-associated pneumonia rate was 9.6 %, sinusitis 1.5 %, central venous catheter-associated infection 3.5 %, central venous catheter-associated bacteraemia 4.8 %, catheter-associated urinary tract infection 7.8 % and bacteraemia 4.5 %. The incidence density rate of ICU-acquired infections was 20.3 ‰ patient-days. Ventilator-associated pneumonia and sinusitis rates were 9.4 and 1.5 ‰ ventilation-days, respectively. Central venous catheter-associated infection and central venous catheter-associated bacteraemia rates were 2.8 and 3.8 ‰ catheter-days, respectively. The catheter-associated urinary tract infection rate was 8.5 ‰ urinary catheter-days and the bacteraemia rate 4.2 ‰ patient-days. Six independent risk factors for ICU-acquired infection were found by stepwise logistic regression analysis: absence of infection on admission, age > 60 years, length of stay, mechanical ventilation, central venous catheter and admission to one particular unit. A total of 410 strains of micro-organisms were isolated, 16.8 % of which were Staphylococcus aureus (58.0 % methicillin-resistant). Conclusion: This prospective study using standardised collection of data on the ICU-acquired infection rate in five ICUs identified six risk factors. It also emphasized the difficulty of achieving truly standardised definitions and methods of diagnosis of such infections.

Key words EpidemiologyIncidence studyIntensive careNosocomial infection
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Copyright information

© Springer-Verlag Berlin Heidelberg 1998