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The Extended Prevalence of Infection in the ICU Study : EPIC II
Vincent, Jean-Louis (Université libre de Bruxelles, Erasme Hospital, Department of Intensive Care)
Rello Condomines, Jordi (Universitat Autònoma de Barcelona. Departament de Medicina)
Marshall, John (University of Toronto, St. Michael's Hospital, Interdepartmental Division of Critical Care Medicine, Department of Surgery)
Silva, Eliezer (Hospital Israelita Albert Einstein (Sao Paolo, Brazil), Department of Intensive Care)
Anzueto, Antonio (University of Texas Health Science Center (San Antonio, USA), Department of Pulmonary/Critical Care)
Martin, Claude D. (Hôpital Nord (Marseille, France), Department of Anesthesiology ant Intensive Care)
Moreno, Rui (Hospital de St Antonio dos Capuchos (Lisbon, Portugal), Department of Intensive Care)
Lipman, Jeffrey (Royal Brisbane and Womens’ Hospital (Herston, Australia), Department of Intensive Care)
Sakr, Yasser (Friedrich-Schiller University (Jena, Germany), Department of Anesthesiiology and Intensive Care)
Reinhart, Konrad (Friedrich-Schiller University (Jena, Germany), Department of Anesthesiiology and Intensive Care)

Date: 2009
Abstract: Context: Infection is a major cause of morbidity and mortality in intensive care units worldwide. However, there is still relatively little information about the global epidemiology of such infections. Objective: To provide an up-to-date picture of the extent and patterns of infection in intensive care units around the world. Design: One-day point prevalence study on May 8, 2007. Setting: A total of 1265 intensive care units from 76 countries. Patients: All patients present on one of the participating units on the study day. Main outcome measures: Demographic, physiologic, bacteriological, and therapeutic data were collected, along with outcome data at intensive care unit and hospital discharge. Results: On the day of the study, 51% of patients were considered to be infected. Seventy-one percent of all patients were receiving antibiotics. Sixty-four percent of infections were of respiratory origin, and 70% of infected patients had positive microbiological isolates; Gram-negative organisms were isolated from 62% of infectious episodes, Gram-positive organisms from 47%, and fungi from 19%. Gram-negative organisms were much less prevalent in North America, Europe and Oceania than in other regions. Patients who had longer intensive care unit stays prior to the study day had higher rates of infection, especially infections due to resistant staphylococci, Acinetobacter, Pseudomonas species and fungi. Intensive care unit (25 versus 11%) and hospital (33% versus 15%) mortality rates were more than double in infected than in non-infected patients (both P<0. 001). In multivariable analysis, infection was independently associated with an increased risk of hospital mortality (odds ratio 1. 52 [1. 37-1. 69], P<0. 001). Conclusions: Infections are very common in contemporary intensive care unit patients, and risk of infection increases with duration of intensive care unit stay. In this large cohort, infection was independently associated with an increased risk of hospital death.
Note: Premi a l'excel·lència investigadora. 2010
Rights: Tots els drets reservats
Language: Anglès.
Document: article ; recerca ; acceptedVersion
Subject: PREI 2010
Published in: JAMA, Vol. 302, Núm. 21 (2009) , p. 1-49, ISSN 0098-7484

DOI: 10.1001/jama.2009.1754

49 p, 235.4 KB

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 Record created 2011-02-23, last modified 2016-06-11

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