Alberti Corinne, Brun-Buisson Christian, Burchardi Hilmar, Martin Claudio, Goodman Sergey, Artigas Antonio, Sicignano Alberto, Palazzo Mark, Moreno Rui, Boulmé Ronan, Lepage Eric, Le Gall Roger
Department of Biostatistics, Saint-Louis Hospital, Paris, France.
Intensive Care Med. 2002 Feb;28(2):108-21. doi: 10.1007/s00134-001-1143-z. Epub 2001 Dec 4.
To examine the incidence of infections and to describe them and their outcome in intensive care unit (ICU) patients.
International prospective cohort study in which all patients admitted to the 28 participating units in eight countries between May 1997 and May 1998 were followed until hospital discharge.
A total of 14,364 patients were admitted to the ICUs, 6011 of whom stayed less than 24 h and 8353 more than 24 h.
Overall 3034 infectious episodes were recorded at ICU admission (crude incidence: 21.1%). In ICU patients hospitalised longer than 24 h there were 1581 infectious episodes (crude incidence: 18.9%) including 713 (45%) in patients already infected at ICU admission. These rates varied between ICUs. Respiratory, digestive, urinary tracts, and primary bloodstream infections represented about 80% of all sites. Hospital-acquired and ICU-acquired infections were documented more frequently microbiologically than community-acquired infections (71% and 86%, respectively vs. 55%). About 28% of infections were associated with sepsis, 24% with severe sepsis and 30% with septic shock, and 18% were not classified. Crude hospital mortality rates ranged from 16.9% in non-infected patients to 53.6% in patients with hospital-acquired infections at the time of ICU admission and acquiring infection during the ICU stay.
The crude incidence of ICU infections remains high, although the rate varies between ICUs and patient subsets, illustrating the added burden of nosocomial infections in the use of ICU resources.
调查重症监护病房（ICU）患者感染的发生率，描述感染情况及其转归。
一项国际前瞻性队列研究，对1997年5月至1998年5月期间在8个国家28个参与单位收治的所有患者进行随访直至出院。
共有14364例患者入住ICU，其中6011例住院时间少于24小时，8353例住院时间超过24小时。
在ICU入院时共记录到3034次感染发作（粗发病率：21.1%）。在住院时间超过24小时的ICU患者中，有1581次感染发作（粗发病率：18.9%），其中713例（45%）在ICU入院时已被感染。这些发生率在不同的ICU之间有所差异。呼吸道、消化道、泌尿道及原发性血流感染约占所有感染部位的80%。医院获得性感染和ICU获得性感染在微生物学上的记录比社区获得性感染更频繁（分别为71%和86%，而社区获得性感染为55%）。约28%的感染与脓毒症相关，24%与严重脓毒症相关，30%与感染性休克相关，18%未分类。粗住院死亡率范围从非感染患者的16.9%到ICU入院时存在医院获得性感染且在ICU住院期间发生感染的患者的53.6%。
ICU感染的粗发病率仍然很高，尽管发生率在不同的ICU和患者亚组之间有所不同，这说明了医院感染在ICU资源使用中的额外负担。
