Patients With ICU Hospital-Acquired Infections Face Higher Risk of Death: Study

The findings of a new study examine the risks associated with intensive care unit (ICU) infections, warning of an increased risk of death for individuals who contract the infections in the hospital.

Compared to patients who become infected at home or in the community and then go to the hospital for treatment, patients who are admitted to the hospital for other reasons and contract the infection while in the ICU face a higher risk of death, according to a report published this week in the Journal of the American Medical Association (JAMA).

Researchers from Europe conducted a worldwide study of 1,150 medical centers in 88 countries on September 13, 2017, evaluating data on more than 15,000 adults who were admitted to the ICU.

According to the findings, 54% of the patients had a suspected or proven infection. Of those, 22% were infections acquired in the intensive care unit.

Overall, the rate of death from infections was 30%. However, patients with hospital-acquired infections had a 32% higher risk of death than those who acquired their infection outside of the hospital.

Death rates were higher among patients who were infected with antibiotic-resistant bacteria, including microorganisms like vancomycin-resistant Enterococcus, Klebsiella resistant to β-lactam antibiotics, including third-generation cephalosporins and carbapenems, or carbapenem-resistant Acinetobacter. 

There is a wide range of transmission methods for hospital acquired infections. One study linked ICU stethoscopes to bacterial infections and another study indicated contaminated floors could lead to hospital acquired superbug infections that cannot be treated with antibiotics. Hospital-acquired infections can also spread from bacteria in sink drains and plumping that splashes out into sinks and counters.

The study also found that 70% of hospital ICU patients were given at least one antibiotic, whether they had a confirmed infection or not.

Many of the prescriptions given in the hospital during the new study were inappropriate. Only 35% of infections in the study were positive for infections treatable with antibiotics. About 28% were given as a precautionary and not needed and the other half were given because doctors made prescribing decisions based on the patient’s symptoms and available evidence.

An editorial that accompanied the study noted that many of the patients with hospital-acquired infections were infected with gram-negative bacteria. These difficult-to-treat infections are highly resistant to antibiotics commonly used in hospitals and are commonly found in ICU units.

“This likely reflects the overall microbial ecosystem in the participating ICU units and is a cause for concern,” the editorial authors wrote.