Background:
@EN Intensive care units(ICUs) probably represent the single largest identifiable source of nosocomial infection. Although nosocomial infection has become a major health problem because of excessive morbidity, personal distress, and cost, no
previous
studies have clearly demonstrated the incidence of nosocomial infection and the case-attributable mortality in Korea.
@ES Methods:
@EN In order to evaluate the incidence, the attributable mortality and risk factors of nosocomial infection in patients receiving intensive care, we have performed a prospective study based on the identification of all patients who developed
nosocomial
infections in the ICU of Korea University Guro Hospital during a 4-month period(from January 1993 to April 1993).
@ES Results:
@EN 1) The incidence of nosocomial infections in ICU was 39.7%(58 infections/146 admissions), and the percentage distribution by site was as follows: Pneumonia consitituted 39.7% of all nosocomial infecitons, tracheobronchitis 20.7%, urinary
tract
infection 13.8%, bacteremia 10.3%, phlebitis 6.9%, postoperative wound infection 5.2%, and others 3.4%.
2) Frequently isolated causative microorganisms of nosocomial infection were Methicillin-resistent Staphylococcus aureus(27%), Klebsiella species(24%), and Pseudomonas aeruginosa(17%).
3) The risk factors associated with nosocomial infection were long duration of ICU stay, admission to neurosurgery, the presence of shock or coma on admission, previous use of antibiotics, use of invasive procedures, peripheral leukocytosis, low
serum
albumin level, and high serum creatinine level.
4) The mortality rate in patients with nosocomial infection was 40%(20 deaths/58 infections) compared with 11%(10 deaths/88 non-infected patients)in patients without nosocomial infection; attributable mortality was 22%. The risk factors that
attributed
to the increment in the mortality rate were the presence of shock or coma on admission, long duration of ICU stay, use of invasive procedures, and steroid, peripheral leukocytosis, and high serum creatinine level.
@ES Conclusion:
@EN Nosocomial infections are frequent problems in critical care patients and associated with considerable morbidity, mortality, and cost. In addition, use of invasive procedures, revious use of antibiotics, low serum albumin level, and high
serum
creatinine level are closely related risk factors of nosocomial infection in the ICU and nosocomial infection-related deaths.
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