European surveillance of ICU-acquired infections (HELICS-ICU), 20042005: ICU-acquired pneumonia
Abstract number: 1732_204
Suetens C., Savey A., Palomar M., Hiesmayr M., Lepape A., Morales I., Gastmeier P., Schmit J.C., Valinteliene R., Fabry for the HELICS-ICU Data Centre J., Health Scientific Institute of Public, Brussels
Objective: To describe the 20042005 results of the European surveillance of ICU-acquired pneumonia in the HELICS-ICU (HI) network (http://helics.univ-lyon1.fr).
Methods: Six patient-based networks (Austria, Belgium, France, Spain, Luxemburg and Lithuania), 2 piloting countries (Norway, Slovakia) and 1 unit-based (Germany) surveillance networks contributed data on 15,161 episodes of ICU-acquired pneumonia (PN) from 721 ICUs between Jan 2004 and Dec 2005. Since the HI protocol excludes patients with a length of stay (LOS) of <3 days in the ICU, data from Germany (no denominator data for patients staying >2 days) were excluded for the calculation of indicators, but included for the description of infections.
Results: Of 87,353 patients staying more than 2 days in the ICU, 8.7% acquired a PN (intubator-associated 89.9%). The median incidence density varied from 3.3 PN episodes per 1000 patient-days (pd) (distribution ICUs P25 0.0; P75 7.7) in ICUs with less than 30% patients intubated, to 6.4 (P25 3.1; P75 10.4) in ICUs with 3059% patients intubated and 9.4 (P25 4.8; P75 13.9) in ICUs with ≥60% of patients intubated. The incidence was higher in polyvalent ICUs (P50 7.6 PN/1000 patient-days) than in surgical (P50 4.4) and medical (P50 5.7) ICUs. The most frequently reported micro-organism was S. aureus (19.6%) with an average MRSA/SA percentage resistance of 38.7%. There were marked differences in the relative frequency of isolated micro-organisms between countries (table).
The diagnosis of PN was confirmed by quantitative culture (HELICS definition PN1 or PN2) in 79% in FR, 54% in ES, 32% in AT, 21% in BE, 15% in LT and 7% in LU. In the piloting countries (limited numbers), 71% was confirmed in Norway and 0% in Slovakia.
Conclusion: Although underlying differences in diagnostic practices persist, the compatibility with the HI protocol is increasing. The level 1 (unit-based) data presented here provide sufficient indicators for continuous follow-up of infection rates within the ICU and limited risk-adjusted inter-ICU comparisons with a low workload.
|Session name:||European Society of Clinical Microbiology and Infectious Diseases|
|Location:||ICC, Munich, Germany|
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