International Study of the Prevalence and Outcomes of Infection in Intensive Care Units

Vincent, Jean-Louis, Rello, Jordi, Marshall, John, Silva, Eliezer, Anzueto, Antonio, Martin, Claude D., Moreno, Rui, Lipman, Jeffrey, Gomersall, Charles, Sakr, Yasser and Reinhart, Konrad (2009) International Study of the Prevalence and Outcomes of Infection in Intensive Care Units. Journal of the American Medical Association, 302 21: 2323-2329. doi:10.1001/jama.2009.1754

Author Vincent, Jean-Louis
Rello, Jordi
Marshall, John
Silva, Eliezer
Anzueto, Antonio
Martin, Claude D.
Moreno, Rui
Lipman, Jeffrey
Gomersall, Charles
Sakr, Yasser
Reinhart, Konrad
Title International Study of the Prevalence and Outcomes of Infection in Intensive Care Units
Journal name Journal of the American Medical Association   Check publisher's open access policy
ISSN 0098-7484
Publication date 2009-12
Sub-type Article (original research)
DOI 10.1001/jama.2009.1754
Volume 302
Issue 21
Start page 2323
End page 2329
Total pages 7
Editor Dr. Catherine D DeAngelis
Place of publication Chicago, USA
Publisher American Medical Association
Collection year 2010
Language eng
Subject 11 Medical and Health Sciences
Abstract Context Infection is a major cause of morbidity and mortality in intensive care units (ICUs) worldwide. However, relatively little information is available about the global epidemiology of such infections. Objective To provide an up-to-date, international picture of the extent and patterns of infection in ICUs. Design, Setting, and Patients The Extended Prevalence of Infection in Intensive Care (EPIC II) study, a 1-day, prospective, point prevalence study with follow-up conducted on May 8, 2007. Demographic, physiological, bacteriological, therapeutic, and outcome data were collected for 14 414 patients in 1265 participating ICUs from 75 countries on the study day. Analyses focused on the data from the 13 796 adult (>18 years) patients. Results On the day of the study, 7087 of 13 796 patients (51%) were considered infected; 9084 (71%) were receiving antibiotics. The infection was of respiratory origin in 4503 (64%), and microbiological culture results were positive in 4947 (70%) of the infected patients; 62% of the positive isolates were gram-negative organisms, 47% were gram-positive, and 19% were fungi. Patients who had longer ICU stays prior to the study day had higher rates of infection, especially infections due to resistant staphylococci, Acinetobacter, Pseudomonas species, and Candida species. The ICU mortality rate of infected patients was more than twice that of noninfected patients (25% [1688/6659] vs 11% [ 682/6352], respectively; P < .001), as was the hospital mortality rate (33% [2201/6659] vs 15% [ 942/6352], respectively; P < .001) (adjusted odds ratio for risk of hospital mortality, 1.51; 95% confidence interval, 1.36-1.68; P < .001). Conclusions Infections are common in patients in contemporary ICUs, and risk of infection increases with duration of ICU stay. In this large cohort, infection was independently associated with an increased risk of hospital death.
Q-Index Code C1
Q-Index Status Confirmed Code
Additional Notes for the EPIC II Group of Investigators

Document type: Journal Article
Sub-type: Article (original research)
Collections: 2010 Higher Education Research Data Collection
School of Medicine Publications
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Created: Sun, 13 Dec 2009, 00:04:58 EST