La sorveglianza delle infezioni in terapia intensiva: Risultati preliminari di uno studio multicentrico GiViTI su 71 TI.

Abstract

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 5814 patients (98% of eligible patients) were surveyed. The overall incidence of infected patients was 43%. The incidence of patients with nosocomial infection was 18% (1062 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