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A Journal on Anesthesiology, Resuscitation, Analgesia and Intensive Care
SEPSIS SMART 2004 - Milan, May 12-14, 2004
Minerva Anestesiologica 2004 May;70(5):321-8
Infection surveillance in Intensive Care Units. Preliminary results of a multicenter GiViTI study in 71 Italian ICUs
Malacarne P. 1, Stella A. 2, Giudici D. 3, Bertolini G. 2
1 Rianimazione, Azienda Ospedaliera Universitaria Pisana, Pisa
2 Istituto di Ricerche Farmacologiche “Mario Negri”: Centro di Ricerche Cliniche per le Malattie Rare Aldo e Cele Daccò, Ranica, Bergamo
3 Servizio di Anestesia e Rianimazione, Ospedale S. Raffaele, Milano a nome del gruppo GiViTI: Gruppo Italiano per la Valutazione degli Interventi in Terapia Intensiva
Aim. Infection surveillance and control in ICU is believed to be a means to improve the quality of assistance. The importance of this activity is supported by both epidemiological (rate and severity of infection in ICU) and economic (efficiency, cost-benefit and cost-effectiveness analysis) evaluations. Many authors thinks that infection surveillance and control should be performed with a routine tool in order to obtain remarkable data without too much time loss, and used by many ICUs, in order to compare the data.
Methods. A prospective observational study in 71 Italian ICUs participating in GiViTi. All patients admitted in each ICU during 6 month (except those discharged alive within 48 hours from admission) were enrolled and surveyed. Demographic and clinical data, data relating to nosocomial and at admission infections, risk factors, responsible micro-organisms, antibiotics use and outcome were collected.
Results. A total of 5 814 patients (98% of eligible patients) were surveyed. The overall incidence of infected patients was 43%. The incidence of patients with nosocomial infection was 18% (1 062 patients). Pneumonia, bacteraemia and urinary tract were the main sites. The major isolated micro-organism responsible of infection were staphylococcus (29.7%) and pseudomonas (16.2). Only 17% of all patients was not treated with antibiotics, and 72% of patients without infection was treated with antibiotics.
Conclusion. These preliminary data confirm the importance of infection in ICU and the need of continuous surveillance. We propose a tool that can be useful for continuous and multicentric infection surveillance in ICU.