Mortality in German intensive care units: dying from or with a nosocomial infection?

To describe mortality from intensive care unit acquired infections in German ICUs. The hospital infection surveillance system (KISS = Krankenhaus-Infektions-Surveillance-System) started in Germany in January 1997 as a nationwide surveillance project for the voluntary registration of nosocomial infections. For ICUs reporting focuses on pneumonia and primary bloodstream infections. The data collected for each patient who acquires a nosocomial infection include outcome information. Data of a recent French study and the Statistical Yearbook were used to estimate the annual number of ICU acquired infections contributing to death in Germany. Data from 897 774 ICU patients were considered for the analysis (January 1997-June 2004). ICU mortality of patients with nosocomial pneumonia was 8.8 %, of patients with primary bloodstream infection was 10,9 %. Of the ICU patients with nosocomial pneumonia and primary bloodstream infections about 3554 die annually, in about 1131 cases the nosocomial infection was the cause of death. It may be estimated that the ICU acquired cases of pneumonia and primary bloodstream infection contributed to the death of about 2400 patients annually in Germany. Because of the substantial mortality of patients with ICU acquired infections preventive measures have a high priority. Further studies leading to improved infection control measures are very wellcome.