Tuesday, December 1, 2009

Infections in the ICU: New data, new insights

This week's JAMA contains an important paper and editorial for all of us in infectious diseases and hospital epidemiology. The EPIC II study was a one-day point prevalence study of infections in 1,265 ICUs in 75 countries involving 13,796 adult patients.

Key findings include:
  • 51% of the patients had infections (this includes both community-acquired and hospital-acquired)
  • 71% of the patients were receiving antibiotics
  • Gram-negative organisms accounted for 61% of the infections (up from 39% in the EPIC-I study done 15 years ago)
  • MRSA accounted for 10% of infections
In my medical school psychiatry course, I learned that a delusion is a fixed false belief. And it's a delusion to continue to think that hospitals should fixate on MRSA and continue with a search and destroy strategy. The gram-negatives are a major threat not only because they are increasing in incidence but also because the therapeutic options are quite limited. 

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