An international study that examined the extent of infections in nearly 1,300 intensive care units (ICUs) in 75 countries found that about 50 percent of the patients were considered infected, with infection associated with an increased risk of death in the hospital. The full study will appear in the December 2 issue of JAMA.
“Infection and related sepsis are the leading cause of death in non-cardiac ICUs, with mortality rates that reach 60 percent and account for approximately 40 percent of total ICU expenditures,” the authors write. International data related to the prevalence, risk factors, microorganisms causing the infections and outcomes of infection are necessary to increase awareness of the impact of infection. However, little information is available about the global epidemiology of infections in ICUs.
The authors also found a relationship between the number of days spent in the ICU before the study day and the rate of infection, as the infection rate increased from 32 percent for patients with an ICU stay of 0 or 1 days to more than 70 percent for patients with an ICU stay of more than 7 days. Infected patients had longer ICU and hospital lengths of stay than those not infected. The ICU mortality rate of infected patients was more than twice that of non-infected patients, as was the hospital mortality rate.
In examining infection rates in different areas of the world, Central and South America had the highest infection rate and Africa had the lowest. Also, infection rates were related to health care expenditure, with higher rates of infection reported in countries that had a lower proportion of gross domestic product devoted to health care.
“The study demonstrates that infections remain a common problem in ICU patients,” the authors write. “These important data provide a picture of patterns of infection around the world, which can enhance understanding of global and regional differences and provide pointers to help optimize infection prophylaxis and management.”