Hospital-acquired infections pose significant risk to ICU patients

A hospital-acquired infection significantly increases the risk of death among patients in the intensive-care unit, according to a recent multicenter European study.

Analysis of hospital-acquired bloodstream infections and pneumonia in 119,699 patients in 537 ICUs in 10 European countries from 2005 to 2008 found that bloodstream infections nearly tripled the risk of death; pneumonia doubled the risk. Pneumonia also increased length of stay in the ICU. Antibiotic-resistant microorganisms increased the risk of death by another 20% and didn’t significantly lengthen ICU stays.

“Prevention of healthcare-related infections needs to be reasserted and emphasized as an absolute priority,” the authors write. They note that “the additional effect of the most common antimicrobial resistance patterns is comparatively low.” However, they caution that their findings may not apply to “severe patterns of resistance that cause virtually untreatable infections,” which are still rare.

In an editorial accompanying the study, Jean-Louis Vincent of Erasme University Hospital in Brussels warns against minimizing the problem of antibiotic resistance on the basis of the researchers’ findings. “Microbial resistance does matter, and the results of this study should not discourage attempts to control multidrug-resistant bacteria,” he writes.

The hospital-acquired infections in study patients were caused by the 4 microorganisms found most often in ICUs: Staphylococcus aureus, Escherichia coli, Acinetobacter baumannii, and Pseudomonas aeruginosa. P. aeruginosa had the highest burden of health-care acquired infections because of its high prevalence and the pathogenicity of both its drug-sensitive and drug-resistent strains, the researchers write.

The study was published in Lancet Infectious Diseases 2011;11(1):30-38.