International Study of the Prevalence and Outcomes of Infection in Intensive Care Units

Vincent, Jean‐Louis; Rello, Jordi; Marshall, John C.; Silva, Eliezer; Anzueto, Antonio; Martin, Claude; Moreno, Rui P.; Lipman, Jeffrey; Gomersall, Charles D.; Sakr, Yasser; Reinhart, Konrad

doi:10.1001/jama.2009.1754

Cited by 3,075 publications

(2,462 citation statements)

References 34 publications

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“…Approximately 80% of IFIs are due to Candida species. In a worldwide ICU prevalence study, Candida was the third most frequently isolated microorganism accounting for 17% of all infections [7,8]. The rank order of Candida in bloodstream infections varies by country and is influenced by the type of patients studied.…”

Section: Invasive Candidiasismentioning

confidence: 99%

Intensive care medicine research agenda on invasive fungal infection in critically ill patients

et al. 2017

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Purpose:To describe concisely the current standards of care, major recent advances, common beliefs that have been contradicted by recent trials, areas of uncertainty, and clinical studies that need to be performed over the next decade and their expected outcomes with regard to Candida and Aspergillus infections in non-neutropenic patients in the ICU setting. Methods:A systematic review of the medical literature taking account of national and international guidelines and expert opinion. Results:Severe invasive fungal infections (IFIs) are becoming increasingly frequent in critically ill patients. Approximately 80% of IFIs are due to Candida spp. and 0.3-19% to Aspergillus spp. Recent observations emphasize the necessity of building a worldwide sentinel network to monitor the emergence of new fungal species and changes in susceptibility. Robust data on the attributable mortality are essential for the design of clinical studies with mortality endpoints. Although early antifungal therapy for Candida has been recommended in patients with risk factors, sepsis of unknown cause, and positive Candida serum biomarkers [β-1 → 3-d-glucan (BDG) and Candida albicans germ tube antibody (CAGTA)], its usefulness and influence on outcome need to be confirmed. Future studies may specifically address the optimal diagnostic and therapeutic strategies for patients with abdominal candidiasis. Better knowledge of the pharmacokinetics of antifungal molecules and tissue penetration is a key issue for intensivists. Regarding invasive aspergillosis, further investigation is needed to determine its incidence in the ICU, its relationship with influenza outbreaks, the clinical impact of rapid diagnosis, and the significance of combination treatment. Conclusions:Fundamental questions regarding IFI have to be addressed over the next decade. The clinical studies described in this research agenda should provide a template and set priorities for the clinical investigations that need to be performed.

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Section: Invasive Candidiasismentioning

confidence: 99%

Intensive care medicine research agenda on invasive fungal infection in critically ill patients

et al. 2017

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“…9 In addition, hospital stays with ICU involvement are 2.5 times costlier than hospital stays with no ICU stay. 40 Therefore, patients in the ICU with NV-HAP contribute to increased LOS, mortality, and cost. [40][41][42] The societal impact of NV-HAP on the patient can be seen by comparing discharge disposition with patient location prior to admission; patients admitted in a hospital should be able to return to their previous level of function, and require the same level of care.…”

Section: Discussionmentioning

confidence: 99%

“…40 Therefore, patients in the ICU with NV-HAP contribute to increased LOS, mortality, and cost. [40][41][42] The societal impact of NV-HAP on the patient can be seen by comparing discharge disposition with patient location prior to admission; patients admitted in a hospital should be able to return to their previous level of function, and require the same level of care. Regarding discharge to SNFs, the national average among Medicare patients is 9% 43 ; however, for patients who acquire NV-HAP, there is an associated 4.13-fold increased risk of discharge to SNFs.…”

Section: Discussionmentioning

confidence: 99%

Understanding factors that impact on public and patient’s risk perceptions and responses toward Clostridium difficile and other health care-associated infections: A structured literature review

Burnett

Johnston

Kearney

et al. 2013

American Journal of Infection Control

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“…(Doyle et al, 2011) It is estimated that more than half of ICU patients would have an infection (Vincent et al, 2009) and most of these will have originated in the respiratory tract. In particular critically ill patients who require intubation and mechanical ventilation are at risk of ventilator-associated pneumonia (VAP).…”

Section: Background (Max 7000 Words)mentioning

confidence: 99%

Implementing selective digestive tract decontamination in the intensive care unit: A qualitative analysis of nurse-identified considerations

et al. 2014

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International Study of the Prevalence and Outcomes of Infection in Intensive Care Units

Cited by 3,075 publications

References 34 publications

Intensive care medicine research agenda on invasive fungal infection in critically ill patients

Intensive care medicine research agenda on invasive fungal infection in critically ill patients

Understanding factors that impact on public and patient’s risk perceptions and responses toward Clostridium difficile and other health care-associated infections: A structured literature review

Implementing selective digestive tract decontamination in the intensive care unit: A qualitative analysis of nurse-identified considerations

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