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Mortality Attributable to Nosocomial Infections in the ICU

Published online by Cambridge University Press:  02 January 2015

Jean-Yves Fagon ,
Ana Novara ,
François Stephan ,
Emmanuelle Girou  and
Michel Safar
Jean-Yves Fagon*
Affiliation:
Service de Réanimation Médicale, Hôpital Broussais, Paris, France
Ana Novara
Affiliation:
Service de Réanimation Médicale, Hôpital Broussais, Paris, France
François Stephan
Affiliation:
Service de Réanimation Médicale, Hôpital Broussais, Paris, France
Emmanuelle Girou
Affiliation:
Service de Réanimation Médicale, Hôpital Broussais, Paris, France
Michel Safar
Affiliation:
Service de Réanimation Médicale, Hôpital Broussais, Paris, France
*
Service de Réanimation Médicale, Hôpital Broussais, 96 rue Didot, 75014 Paris, France
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Abstract

Although a direct relationship between nosocomial infection and mortality in intensive care unit (ICU) patients has not always been demonstrated formally, it is possible to conclude that nosocomial infections increase the risk of death in critically ill patients. A more precise analysis indicates that: 1) this effect is highly probable for pneumonia, doubtful for bacteremia, and uncertain for urinary tract infection; 2) risk increases with duration of stay in the ICU; 3) bacterial etiology modifies the risk; and 4) this effect is stronger in less severely ill patients, probably because the severity of underlying disease remains the most significant factor.

Type
From the Third International Conference on the Prevention of Infection
Information
Infection Control & Hospital Epidemiology , Volume 15 , Issue 7 , July 1994 , pp. 428 - 434
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1994

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References

1.Wenzel, RF! The mortality of hospital-acquired bloodstream infections: need for a new vital statistic? Int J Epidemiol 1988;17:225–227.Google Scholar
2.Wenzel, RP, Thompson, RL, Landry, SM, et al.Hospital-acquired infections in intensive care unit patients: An overview with emphasis on epidemics. Infect Control 1983;4:371–375.Google Scholar
3.Dixon, RE. Effect of infections on hospital care. Ann Intern Med 1978;89:749–753.Google Scholar
4.Knaus, WA, Wagner, DP, Draper, EA, et al.APACHE II: a severity of disease classification system. Crit Cave Med 1985;13:818–329.Google Scholar
5.Freeman, J, McGowan, JE JrMethodologic issues in hospital epidemiology. IV. Risk ratios. confounding, effect modification, and the analysis of multiple variables. Rev Infecf Dis 1988;10:1118–1141.Google Scholar
6.LaForce, FM. The control of infections in hospitals: 1750 to 1950. In: Wenzel, RP, ed. Prevention and Control of Nosocomia1 Infections. Baltimore, MD: Williams&Wilkins; 1987:1–12.Google Scholar
7.McGowan, JE JrBarnes, MW, Finland, M. Bacteremia at Boston City Hospital: occurence and mortality during 12 selected years (19351972). with special reference to hospital-acquired cases. J Infect Dis 1975;132:316–335.Google Scholar
8.Daschner, F, Nadjem, H, Langmaack, H, Sandritter, W. Surveillance, prevention and control of hospital-acquired infections. Infection 1978;6:261–265.Google Scholar
9.Gross, PA, Neu, HC, Aswapokee, P, Van Antwerpen, C, Aswapokee, N. Deaths from nosocomial infections: experience in a university hospital and a community hospital. Am J Med 1980;68:219–223.Google Scholar
10.Gross, PA, Van Antwerpen, C. Nosocomial infections and hospital deaths: a casecontrol study. Am J Med 1983;75:658–661.Google Scholar
11.Craven, DE, Kunches, LM, Lichtenberg, DA, et al.Nosocomial infection and fatality in medical and surgical intensive care unit patients. Arch Intern Med 1988;148:1161–1168.Google Scholar
12.Goldmann, DA, Freeman, J, Durbin, WA. Nosocomial infection and death in a neonatal intensive care unit.J Infect Dis 1983;147:635–641.Google Scholar
13.Bueno-Cavanillas, A. Delgado-Rodriguez, M, Lopez-Luque, A, Schaffino-Cano, S. Galvez-Vargas, R. Influence of nosocomial infection on mortality rate in an intensive care unit. Crit Care Med 1994;22:55–60.Google Scholar
14.Constantini, M, Donisi, PM, Turrin, MG, Diana, L. Hospital acquired infections surveillance and control in intensive care services, results of an incidence study. Eur J Epidemiol 1987;3:347–355.Google Scholar
15.Platt, R, Polk, BEMurdock, B. Rosner, B. Mortality associated with nosocomial urinary-tract infection. N Engl J Med 1982;307:637–642.Google Scholar
16.Rose, R, Hunting, KJ, Townsend, TR, Wenzel, RP. Morbidity/mortality and economics of hospital-acquired bloodstream infections: a controlled study. South Med J 1977;70:1267–1269.Google Scholar
17.Forgacs, IC, Eykyn, SJ, Bradley, RD. Serious infection in the intensive therapy unit: a 15.year study of bacteraemia. Q J Med 1986;60:773–779.Google Scholar
18.Smith, RL, Meixler, SM, Simberkoff, MS. Excess mortality in critically ill patients with nosocomial bloodstream infections, Chest 1991;100:164–167.Google Scholar
19.Martin, MA, Pfaller, MA, Wenzel, RP. Coagulase-negative staphylococcal bacteremia. Mortality and hospital stay. Ann Intern Med 1989;110:9–16.Google Scholar
20.Wey, SB. Mori, M, Pfaller, MA, Woolson, RF, Wenzel, RP. Hospital-acquired candidemia. The attributable mortality and excess length of stay. Arch Intern Med 1988;148:2642–2645.Google Scholar
21.Chastre, J, Fagon, JY. Community-acquired acute pneumonia and respiratory failure. In: Pinsky, MR, Dhainaut, JFA, eds. Pathophysiologic Foundations of Critical Care. Baltimore, MD: Williams and Wilkins; 1993:525–544.Google Scholar
22.Bryan, CS, Reynolds, KL. Bacteremic nosocomial pneumonia. Am Rev Respir Dis 1984;129:293–298.Google Scholar
23.Graybill, JR, Marshall, LW, Charache, P. Wallace, CR, Melvin, VB. Nosocomial pneumonia: a continuing major problem. Am Rev Respir Dis 1973;108:1130–1140.Google Scholar
24.Fagon, JY, Chastre, J, Domart, Y, et al.Nosocomial pneumonia in patients receiving mechanical ventilation: prospective analysis of 52 episodes with the use of a protected specimen brush and quantitative culture techniques. Am Rev Respir Dis 1989;139:877–884.Google Scholar
25.Torres, A, Aznar, R, Gatell, JM, et al.Incidence, risk, and prognosis factors of nosocomial pneumonia in mechanically ventilated patients. Am Rev Respir Dis 1990;142:523–528.Google Scholar
26.Craven, DE, Kunches, LM, Kilinski, V, Lichtenberg, DA, Make, BJ, McCabe, WR. Risk factors for pneumonia and fatality in patients receiving continuous mechanical ventilation. Am Rev Rapir Dis 1986;133:877–884.Google Scholar
27.Craig, CP, Connelly, S. Effect of intensive care unit nosocomial pneumonia on duration of stay and mortality. Am J Infect Control 1984;12:233–238.Google Scholar
28.Leu, HS, Kaiser, DL, Mori, M, Woolson, RF, Wenzel, RP. Hospital-acquired pneumonia: attributable mortality and morbidity. Am J Epidemiol 1989;129:1258–1267.Google Scholar
29.Fagon, JY, Chastre, J, Hance, AJ, Montravers, P, Novara, A, Gibert, C. Nosocomial pneumonia in ventilated patients: a cohort study evaluating attributable mortality and hospital stay. Am J Med 1993;94:281–288.Google Scholar