Our study demonstrates improved detection of specific pathogens with a high intrinsic resistance and positive impact on therapeutic decision-making by additional multiplex-PCR-based analysis of blood samples for infectious agents in patients with new onset of SIRS. Thus, we showed for the first time that PCR test results guide clinical treatment successfully.

This first systematic use of the time-saving LightCycler Septifast test shows that it can detect bacteremia in surgical patients at the ICU, with, in part, negative blood cultures. Positive Septifast test results which cannot be explained by clinical symptoms, occur rarely. The detection of pathological microbes with the Septifast test provides additional findings (72.2 %) for therapeutic decision-making, which can be obtained considerably more rapidly in comparison with conventional microbiological cultures (a few hours versus 2 days). For surgical patients with SIRS and subsequent need of intensive care, a Septifast test should be considered. In conclusion, it is recommended that the test should be further and systematically investigated.

For patients undergoing elective surgery of the pancreas, liver, stomach, and esophagus, considerable differences in demographic factors, frequency, and kind of NI exist. The consequences of NI force surgeons to analyze pre-operative risk factors carefully, assess indications for operation thoroughly, and optimize all controllable parameters.

ICU relocation from the pavillon-based system to a new complex clinic building was not associated with any significant alteration of the microbial spectrum on the surgical ICU. Increasing incidences of resistant Enterococcus and Gram-negative problematic microbes may indicate a general spread of multi-resistant microbes under the steady selecting pressure of a not always adequately initiated antibiotic / antimicrobial therapeutic regimen and underline the required but specific and selected microbiological screening.

The high uptake rates of fluoroquinolones and carbapenems were accompanied by increases in resistances. The resistance rates are influenced by hygiene management and microbiological diagnostics. The extensive use of carbapenems should be reassessed on both units to counter further development of antibiotic resistance.