[National Study of Control of Nosocomial Infection in Intensive Care Units. Evolutive report of the years 2003-2005]

Abstract

Objective: Describe the national rates of acquired invasive device-related infections in the ICU during 2003, 2004 and 2005, their etiology and evolution of the multiresistance markers.

Design: Prospective, observational study.

Scope: Intensive Care Unit or other units where critical patients are admitted.

Patients: 21,608 patients admitted for more than 24 hours in the participating ICUs.

Main variables of interest: Device related infections: pneumonias related with mechanical ventilation (N-MV), urinary infections related with urethral probe (UI-UP) and primary bacteriemias (PB) and/or those related with at risk vascular catheters (BCV).

Results: In 2,279 (10.5%) patients, 3,151 infections were detected: 1,469 N-MV, 808 UI-UP and 874 PB/RVC. Incidence rates ranged from 15.5 to 17.5 N-MV per 1,000 days of mechanical ventilation, 5.0 to 6.7 UI-UP per 1,000 days of urethral probe and 4.0 to 4.7 PB/RVC per 1,000 days of vascular catheter. The predominant etiology in the N-MV was meticillin susceptible Staphylococcus aureus, Pseudomonas aeruginosa and Acinetobacter baumannii. The UI-UP were originated predominantly by Escherichia coli, Candida albicans and Enterococcus faecalis. A. baumannii and E. coli have increased their resistance to imipenem and ciprofloxacin or cefotaxime, respectively, in the last year controlled.

Conclusions: Elevated rates persist in all the infections controlled, without change in the etiology and increase of resistance of gram-negative bacilli.