1. Nosocomial Bloodstream Infection and Clinical Sepsis
- Author
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Hugonnet, S, Sax, H, Eggimann, P., Touveneau, S., Chevrolet, J.C., and Pittet, D.
- Subjects
Male ,Epidemiology ,lcsh:Medicine ,sepsis ,Switzerland/epidemiology ,0302 clinical medicine ,Bloodstream infection ,Medicine ,Hospital Mortality ,benchmarking ,030212 general & internal medicine ,ddc:616 ,Aged, 80 and over ,Cross Infection ,0303 health sciences ,Incidence ,Incidence (epidemiology) ,Middle Aged ,3. Good health ,Intensive Care Units ,Infectious Diseases ,Population Surveillance ,nosocomial infection ,surveillance ,Female ,Switzerland ,Adult ,Microbiology (medical) ,medicine.medical_specialty ,Adolescent ,Cross Infection/ epidemiology/transmission ,lcsh:Infectious and parasitic diseases ,Sepsis ,03 medical and health sciences ,Infectious complication ,Humans ,Population Surveillance/ methods ,Sepsis/ epidemiology/transmission ,lcsh:RC109-216 ,In patient ,Intensive care medicine ,Aged ,030306 microbiology ,Critically ill ,business.industry ,Research ,lcsh:R ,bacterial infections and mycoses ,medicine.disease ,Confidence interval ,Medical intensive care unit ,Cross Infection/*epidemiology/transmission ,Equipment Contamination ,Population Surveillance/methods ,Sepsis/epidemiology/transmission ,Emergency medicine ,business ,human activities - Abstract
Primary bloodstream infection (BSI) is a leading, preventable infectious complication in critically ill patients and has a negative impact on patients' outcome. Surveillance definitions for primary BSI distinguish those that are microbiologically documented from those that are not. The latter is known as clinical sepsis, but information on its epidemiologic importance is limited. We analyzed prospective on-site surveillance data of nosocomial infections in a medical intensive care unit. Of the 113 episodes of primary BSI, 33 (29%) were microbiologically documented. The overall BSI infection rate was 19.8 episodes per 1,000 central-line days (confidence interval [CI] 95%, 16.1 to 23.6); the rate fell to 5.8 (CI 3.8 to 7.8) when only microbiologically documented episodes were considered. Exposure to vascular devices was similar in patients with clinical sepsis and patients with microbiologically documented BSI. We conclude that laboratory-based surveillance alone will underestimate the incidence of primary BSI and thus jeopardize benchmarking.
- Published
- 2004
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