APH 1999, 57, 221-231:

Nosocomial infections in intensive care: results from the Belgian national surveillance, 1996-1998.

C. Suetens, B. Jans, and H. Carsauw

Keywords: nosocomial infections, bacteremia, surveillance, intensive care

In 1996 the Scientific Institute of Public Health - Louis Pasteur (IPH), in collaboration with the Belgian Society of Intensive Medicine and Emergency Medicine, started the national surveillance of pneumonia and bacteremia in intensive care units (ICU). From 1996 to June 1998, 101 hospitals participated during at least one quarter, and 64% of those participated more than one period. A total of 31374 patients were included for analysis.

In 4.7% of the patients a pneumonia with onset later than 48 hours of ICU stay was registered. In 89% of those at least one ventilation day had preceded the infection (RR 10.4%). The number of ventilator-associated pneumonia was 19.0/1000 ventilation-days, varying from 11.9 in coronary surgery to more than 25 in neurosurgery, non-cardiac thoracic surgery, vascular surgery and transplantation. The predominant micro-organisms were Pseudomonas aeruginosa (18.0%), Staphylococcus aureus (17.7%) and Escherichia coli (12.6%).

Bacteremia was reported in 2.4% of the patients. Forty per cent (N=301) of those were secondary to another infection site and 55% (1.3% of the patients) matched the CDC case definition of laboratory confirmed primary bloodstream infection (BSI). The device-adjusted BSI rate was 3.0/1000 catheter-days and varied between 1.5 in coronary surgery to 6. 0 in neurosurgery The predominant micro-organisms in BSI were Staphylococcus epidermidis (33.3%), Staphylococcus aureus (12.8%) and Enterococcus faecalis (7.1%).

Further analysis is needed to identify areas for prevention of ICU-acquired infections and to improve the inter-ICU comparability of infection rates according to the risk profile of the different ICU populations.