Increased risk of bloodstream and urinary infections in intensive care unit (ICU) patients compared with patients fitting ICU admission criteria treated in regular wards

Catheter-Associated Bloodstream Infections in General Medical Patients Outside the Intensive Care Unit: A Surveillance Study

“…Although multiple studies of the incidence of CA-BSIs in ICU patients have been done, [14][15][16] only a few investigators have examined the incidence of these infections in non-ICU inpatient wards. 9,[17][18][19] In our study, which, to our knowledge, is the largest prospective cohort study performed in the United States to date, we found the incidence of CA-BSIs in non-ICU, general medical patients to be comparable to the rate of CA-BSIs in ICU patients.…”

“…20 The reason for this similarity with ICUs is unclear. In a facility with a shortage of ICU beds, Mnatzaganian et al 19 examined ward patients who qualified as "critically ill," on the basis of criteria derived from the Society of Critical Care Medicine, and reported lower rates of BSI among critically ill patients housed in regular wards, compared with the rate among ICU patients. Although other factors, such as antibiotic utilization and ward-specific processes, might influence the incidence of CA-BSI, the findings of Mnatzaganian et al 19 argue against increased severity of illness as the primary risk factor associated with high rates of CA-BSI.…”

Risk factors for healthcare-associated urinary tract infection and their applications in surveillance using hospital administrative data: a systematic review

“…4,22 Three studies were undertaken in the middle-income countries of Brazil, 24 India 23 and Egypt. 39 Two studies 23,34 involved paediatric populations, with the remaining 21 papers addressing adult populations, including patients from general wards, 4,20,22,26,28,36,37,39,41 patients in intensive care units (ICUs), 29e31,33,38,40 surgical patients, 35 stroke patients, 32 orthopaedic patients, 27 hip fracture admissions, 21 spinal injury patients 25 and renal transplant patients. 24 The CASP scores for the three caseecontrol studies ranged from nine 22 to six, 20 whilst the prevalence studies, using the adjusted CASP cohort study tool, scored between five 4,37 and 11 36 out of 12.…”

“…,36,37 Thus, 18 of the 23 papers contributed data to the PAR% calculations. PAR% values were calculated for 35 significant risk factors for HCA UTI, and 26 were also independent risk factors.…”

Urinary tract colonization and infection in critically ill patients

“…These observations are probably due to the differences in the duration of bladder catheterization and catheter care, which were not included in the analysis. 29 In developing countries, the incidence of nosocomial infections associated to medical devices is 3-to 5-fold higher than that in developed countries. The factors that can explain these differences are the lack of in-hospital infection control programs and limitations in resources ---including the availability of glycerinated alcohol---the few existing accredited hospital institutions, the low nurse/patient ratio, the high proportion of nursing personnel with limited experience, and the use of obsolete technology.…”