Montrucchio Giorgia, Sales Gabriele, Catozzi Giulia, Bosso Stefano, Scanu Martina, Vignola Titty Vita, Costamagna Andrea, Corcione Silvia, Urbino Rosario, Filippini Claudia, De Rosa Francesco Giuseppe, Brazzi Luca
Department of Surgical Sciences, University of Turin, 10126 Turin, Italy.
Department of Anaesthesia, Critical Care and Emergency, Città Della Salute e Della Scienza Hospital, Corso Dogliotti 14, 10126 Turin, Italy.
J Clin Med. 2022 Apr 28;11(9):2482. doi: 10.3390/jcm11092482.
We evaluated the effectiveness of the Extended Prevalence of Infection in Intensive Care (EPIC) III data collection protocol as an active surveillance tool in the eight Intensive Care Units (ICUs) of the Intensive and Critical Care Department of the University Hospital of Turin. A total of 435 patients were included in a six-day study over 72 ICU beds. 42% had at least one infection: 69% at one site, 26% at two sites and 5% at three or more sites. ICU-acquired infections were the most common (64%), followed by hospital-associated infections (22%) and community-acquired (20%), considering that each patient may have developed more than one infection type. 72% of patients were receiving at least one antibiotic: 48% for prophylaxis and 52% for treatment. Mortality, the length of ICU and hospital stays were 13%, 14 and 29 days, respectively, being all estimated to be significantly different in patients without and with infection (8% vs. 20%; 4 vs. 20 and 11 vs. 50 (p < 0.001). Our data confirm a high prevalence of infections, sepsis and the use of antimicrobials. The repeated punctual prevalence survey seems an effective method to carry out the surveillance of infections and the use of antimicrobials in the ICU. The use of the European Centre for Disease Prevention and Control (ECDC) definitions and the EPIC III protocol seems strategic to allow comparisons with national and international contexts.
我们评估了重症监护病房感染扩展患病率（EPIC）III数据收集方案作为一种主动监测工具在都灵大学医院重症与危重症科的8个重症监护病房（ICU）中的有效性。在一项为期6天、涉及72张ICU床位的研究中，共纳入了435例患者。42%的患者至少发生了1次感染：69%为单部位感染，26%为双部位感染，5%为三个或更多部位感染。考虑到每位患者可能发生不止一种感染类型，ICU获得性感染最为常见（64%），其次是医院相关性感染（22%）和社区获得性感染（20%）。72%的患者至少接受了1种抗生素治疗：48%用于预防，52%用于治疗。死亡率、ICU住院时间和医院住院时间分别为13%、14天和29天，据估计，未感染和感染患者在这些指标上均存在显著差异（8%对20%；4天对20天以及11天对50天（p<0.001）。我们的数据证实了感染、脓毒症和抗菌药物使用的高患病率。重复的时点患病率调查似乎是在ICU中开展感染和抗菌药物使用监测的有效方法。采用欧洲疾病预防控制中心（ECDC）的定义和EPIC III方案似乎对于与国家和国际背景进行比较具有战略意义。
