• S Blot, K Vandewoude, K Blot, and F Colardyn.
• Department of Intensive Care, Ghent University Hospital, Belgium. icu@rug.ac.be
• Acta Clin Belg. 2000 Sep 1; 55 (5): 249-56.

ObjectiveTo investigate prevalence and determine risk factors for colonisation with Gram-negative bacteria in ICU patients.DesignProspective, surveillance study.Setting26-bed surgical and paediatric ICU.Patients159 patients--whereof 22 infants--admitted to the surgical/paediatric ICU over a two-month period.InterventionIn all patients routine microbiological monitoring was performed by thrice weekly oral swabs, urine sampling and, additionally, tracheal aspirates in patients on mechanical ventilation (MV) and by anal swabs once weekly.ResultsPopulation characteristics: Mean age of the adult population was 51.1 +/- 17.6 year. Mean age of the paediatric population was 6.3 +/- 5.3 year. The mean APACHE II-score was 18 +/- 9.1. The mean PRISM-score was 9.7 +/- 5.4. The mean ICU stay was 7.5 +/- 11.4 days. 43.4 percent of patients received mechanical ventilation (MV). The mean number of mechanical ventilation days was 11.1 +/- 14.7 days. 32.1% of patients experienced colonisation with Gram-negative bacteria. Prevalence of colonisation increased with length of ICU stay. The probability of colonisation was 24% after an ICU stay of 3 days (= median ICU stay). Time to colonisation was not different between the controlled sites (p > 0.05). 47% of colonizations were due to multiresistant strains. Higher APACHE II-scores and MV were associated with a higher prevalence of colonisation (p < 0.01). The ICU mortality was 8% among adult and 4% among paediatric patients.ConclusionPatients with high APACHE II-scores, on mechanical ventilation and with an ICU stay of more than 3 days are most at risk for colonisation with Gram-negative bacteria. These patients should be cared with the optimal precautions in the prevention of colonisation and infection.

35 keywords...

hide…