Increased risk of bloodstream and urinary infections in intensive care unit (ICU) patients compared with patients fitting ICU admission criteria treated in regular wards

G. Mnatzaganian, N. Galai, C. L. Sprung, Y. Zitser-Gurevich, M. Mandel, D. Ben-Hur, G. Gurman, M. Klein, A. Lev, L. Levi, Y. Bar-Lavi, F. Zveibil, E. Simchen

Research output: Contribution to journalArticlepeer-review

Abstract

Critically ill patients, eligible for admission into intensive care units (ICUs), are often hospitalized in other wards due to a lack of ICU beds. Differences in morbidity between patients managed in ICUs and elsewhere are unknown, specifically the morbidity related to hospital-acquired infection. Patients fitting ICU admission criteria were identified by screening five entire hospitals on four separate days. Hospital infections within a 30-day follow-up period were compared in ICU patients and in patients on other wards using Kaplan-Meier curves. Residual differences in the patients' case mix between ICUs and other wards were adjusted for utilizing multivariate Cox models. Of 13 415 patients screened, 668 were critically ill. The overall infection rates (per 100 patient-days) were 1.2 for bloodstream infection (BSI) and 1.9 for urinary tract infection (UTI). The adjusted hazard ratios in ICU patients compared with patients on regular wards were 3.1 (P<0.001) for BSI and 2.5 (P<0.001) for UTI. This increased risk persisted even after adjusting for the disparity in the number of cultures sent from ICUs compared with ordinary wards. No interdepartmental differences were found in the rates of pneumonia, surgical wound infections and other infections. Minimizing the differences between characteristics of patients hospitalized in ICUs and in other wards, and controlling for the higher frequency of cultures sent from ICUs did not eliminate the increased risk of BSI and UTI associated with admission into ICUs.

Original languageEnglish (US)
Pages (from-to)331-342
Number of pages12
JournalJournal of Hospital Infection
Volume59
Issue number4
DOIs
StatePublished - Apr 1 2005
Externally publishedYes

Keywords

  • Bloodstream infection (BSI)
  • Intensive care unit (ICU)
  • Pneumonia
  • Regular ward
  • Severity of illness
  • Specialized care unit (SCU)
  • Surgical wound infection
  • Urinary tract infection (UTI)
  • Urine and blood cultures

ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases

Fingerprint Dive into the research topics of 'Increased risk of bloodstream and urinary infections in intensive care unit (ICU) patients compared with patients fitting ICU admission criteria treated in regular wards'. Together they form a unique fingerprint.

Cite this