Septicaemia in a medical intensive care unit. Clinical, biochemical and microbiological data of 109 cases

Abstract

Blood cultures were obtained from 39% of all 574 admissions to our Medical Intensive Care Unit. (ICU); in 109 (19%) a pathogenic organism was demonstrated. 45% of the septicaemias were detected within the first 48 h of ICU stay have been considered as "non ICU-acquired". Septicaemic patients were significantly older, had longer ICU stays and a higher mortality rate (62%) than non septicaemic patients (28%) (p less than 0.05). Gram negative organisms (69%) predominated over gram positive (29%) and Serratia marcescens and coagulase positive Staphylococcus were the most frequently isolated. Shock appeared in 32% and had an extremely high mortality (91%) and was associated with the presence of "multiple species septicaemia". Prior to the septicaemia the survivors differed from the fatalities only in the level of serum albumin; this was significantly lower in patients with gram negative in comparison with gram positive septicaemias and in patients who developed shock. Arterial, pulmonary artery and urinary catheters, and endotracheal devices were used frequently in these patients and were statistically associated with the presence of septicaemia. The airway was the most frequent possible source for the septicaemia.