Infections in Russian ICUs: Results of the Nationwide Multicenter Study

Clinical Microbiology and Antimicrobial Chemotherapy. 2011; 13(4):294-303

Type
Journal article

Abstract

Epidemiological data on the prevalence of infections in ICU is crucial for clinical practice. At the same time in Russia only very limited local information was available. So, the aim of the present study was to evaluate the prevalence and etiology of infections in Russian ICUs as well as a common practice of antimicrobials administration. Overall 250 case report forms were collected (including 178 on patients with infections) from 62 centers in 29 cities during this two-step one day study. 34.8% of patients were on artificial ventilation. The prevalence of infections in ICUs was 34.1% (0–83.3%). In 20.2% of patients with infections septic shock was registered. In 53.4% of cases infection was evaluated as community-acquired, in 46.6% – as nosocomial. At the same time in more than half (62.1%) of patients, initially hospitalized with community-acquired infections, new infectious loci developed during hospitalization. Overall 289 microorganisms were reported during the study. Among them: 253 – bacteria, 29 – fungi, and 7 – viruses. Gram-negative bacteria accounted for 63.7% of all infections and for 72.7% of bacterial infections, respectively. Gram-positive bacteria were reported significantly less frequently (23.9%). Overall mortality rate was 12.7% (1–32%), with significantly more patients died with infections – 30.4% (OR2.4). In 178 patients with documented infection in total there were 381 courses of antimicrobials administered (on average 2.14 per patients). At the same time comparing the antimicrobials profile and the clinically significant microorganisms reported it could be concluded that the real practice of antimicrobials administration is far from optimal.

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