[Prevalence of nosocomial infections in Intensive Care Units in Triveneto area, Italy]

BACKGROUND: Nosocomial infection is one of the most common complications affecting patients admitted in intensive care units (ICU). The aim of this study is to evaluate rates of ICU-acquired infections, potential risk factors for these infections, causative microorganisms and antibiotic resistance patterns. METHODS: A 1-day point-prevalence study was conducted in 39 ICUs in Triveneto area (Italy) in November 1998. The overall study population included 188 patients with mean age of 61.4+/-19.3 years; the mean SAPS II score at entry into the ICU was 44.4+/-16.8 and the median duration of hospitalization was 9 days (range 2-636). RESULTS: A total of 59 patients (31.4\%) had 79 episodes of ICU-acquired infections; pneumonia (45.5\%), bloodstream infection (30.4\%), and urinary tract infection (11.4\%) were the most frequent types of infection. The leading causative microorganisms were S. aureus (24.4\%, 77\% of them were resistant to methicillin), Enterobacteriaceae (24.4\%), P. aeruginosa (23.2\%), fungi (12.2\%), coagulase-negative staphylococci (7.3\%) and Enterococcus spp (4.9\%). Independent risk factors for nosocomial infections were duration of hospitalization >7 days (OR 4.29, 95\% CI 1.82-10.1), SAPS II score >30 (OR 3.34, 95\% CI 1.0-11.18), total parenteral nutrition (OR 2.69, 95\% CI 1.19-6.07) and tracheostomy (OR 1.88, 95\% CI 0.84-4.20). CONCLUSIONS: Nosocomial infections are relatively frequent in Triveneto area ICUs. The predominance of pneumonia and bloodstream infection, and the high frequency of antibiotic-resistant pathogens indicate that resources had to be assigned towards the implementation of control programs of those infections, monitoring of antibiotic resistance and prescription, and antibiotic therapy guidelines.