Epidemiology of intensive care unit (ICU)-acquired infections in a 14-month prospective cohort study in a single mixed Scandinavian university hospital ICU

Background: Our aim was to evaluate the epidemiology of intensive care unit (ICU)‐acquired infections in a prospective cohort study. Methods: Patients with longer than a 48‐h stay in an adult mixed medical–surgical ICU in a tertiary level teaching hospital were included. The incidence (per cent) and incidence density (per 1000 patient days) of ICU‐acquired infections and the device‐associated infection rates per 1000 device days were analysed prospectively in a 14‐month study. Results: Eighty (23.9%) of 335 patients, whose ICU stay was longer than 48 h, acquired a total of 107 infections (1.3 per patient) during their ICU stay, with an infection rate of 48 per 1000 patient days. The most common infections were ventilator‐associated pneumonia (VAP) [33.8% (18.8 per 1000 respiratory days)], other lower respiratory tract infections (LRTIs) (20%) and sinusitis (13.8%). The rate of central catheter‐related (CRI) or primary bloodstream infections was 6.3% (2.2 per 1000 central venous catheter days), and the rate of urinary tract infections was 1.3% (0.5 per 1000 urinary catheter days). The first ICU infection was observed in 58.8% (47/80) of cases within 6 days after admission. The median time from admission to the diagnosis of an ICU‐acquired infection was 4 days (25th–75th percentiles, 4.0–6.0) for VAP, 6.0 days (4.5–7.0) for LRTIs and 9.5 days (6.5–13.0) for CRIs. Conclusions: The rates of urinary tract infections and bloodstream infections were lower than reported previously, differentiating our results from the classic pattern of ICU‐acquired infections, with the exception of the predominance of VAP.