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Surveillance and Infection Control in an Intensive Care Unit

Published online by Cambridge University Press:  21 June 2016

Giovanni Battista Orsi ,
Massimiliano Raponi ,
Cristiana Franchi ,
Monica Rocco ,
Carlo Mancini  and
Mario Venditti
Giovanni Battista Orsi*
Affiliation:
Department of Public Health Sciences, University “La Sapienza” Rome, Rome, Italy Infection Control Committee (CIO) of the Policlinico Umberto I, Rome, Italy
Massimiliano Raponi
Affiliation:
Department of Public Health Sciences, University “La Sapienza” Rome, Rome, Italy
Cristiana Franchi
Affiliation:
Division of Infectious Diseases, Internal Medicine Department, Policlinico Umberto I, Rome, Italy
Monica Rocco
Affiliation:
Intensive Care Unit, Policlinico Umberto I, Rome, Italy
Carlo Mancini
Affiliation:
Department of Public Health Sciences, University “La Sapienza” Rome, Rome, Italy
Mario Venditti
Affiliation:
Division of Infectious Diseases, Internal Medicine Department, Policlinico Umberto I, Rome, Italy
*
Dipartimento di Sanità Pubblica, Università “La Sapienza” Roma, P. le Aldo Moro 5, 00185 Roma, Italy[email protected]
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Abstract

Objective:

To evaluate the effect of an infection control program on the incidence of hospital-acquired infection (HAI) and associated mortality.

Design:

Prospective study.

Setting:

A 2,000-bed, university-affiliated hospital in Italy.

Patients:

All patients admitted to the general intensive care unit (ICU) for more than 48 hours between January 2000 and December 2001.

Methods:

The infection control team (ICT) collected data on the following from all patients: demographics, origin, diagnosis, severity score, underlying diseases, invasive procedures, HAI, isolated microorganisms, and antibiotic susceptibility.

Interventions:

Regular ICT surveillance meetings were held with ICU personnel. Criteria for invasive procedures, particularly central venous catheters (CVCs), were modified. ICU care was restricted to a team of specialist physicians and nurses and ICU antimicrobial therapy policies were modified.

Results:

Five hundred thirty-seven patients were included in the study (279 during 2000 and 258 in 2001). Between 2000 and 2001, CVC exposure (82.8% vs 71.3%; P < .05) and mechanical ventilation duration (11.2 vs 9.6 days) decreased. The HAI rate decreased from 28.7% in 2000 to 21.3% in 2001 (P < .05). The crude mortality rate decreased from 41.2% in 2000 to 32.9% in 2001 (P < .05). The most commonly isolated microorganisms were nonfermentative gram-negative organisms and staphylococci (particularly MRSA). Mortality was associated with infection (relative risk, 2.11; 95% confidence interval, 1.72-2.59; P <.05).

Conclusion:

Routine surveillance for HAI, coupled with new measures to prevent infections and a revised policy for antimicrobial therapy, was associated with a reduction in ICU HAIs and mortality.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 26 , Issue 3 , March 2005 , pp. 321 - 325
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2005

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