[Bacteremias in intensive care]

Abstract

Critical patients are exposed to monitorization and treatment systems which, in addition to the defense mechanism alterations which accompany their basic disease, favor their acquisition of nosocomial infections. Bacteremia's, along with respiratory infections, are the main nosocomial infections seen in Intensive Care Units (ICU's). Between 20 and 30% of the nosocomial bacteremia's occur in ICU's, which represents an incidence rate which varies from 2.5 to 6.7 episodes per 100 admissions, with these occasionally being epidemic type infections. The main origins are intravascular catheters, and respiratory infections, and in 50% of the cases, Gram positive organisms are responsible. The Gram negative bacteremia group is dominated by Pseudomonas spp., and by other non-fermenting Gram negative bacteria. Also, the incidence of candidemia is higher than in case acquired in conventional hospitalization units. The global mortality is set between 30 and 40%, although the mortality directly associated with infection is close to 70%, which confirms the importance of the underlying diseases in the final prognosis of nosocomial infections in critical patients.