Hospital infections disturbingly common worldwide
CTV.ca News Staff
Date: Wednesday Dec. 2, 2009 7:23 AM ET
A huge new study finds that about half of all patients in intensive care wards around the world are battling some kind of infection.
The study, led by Dr. John Marshall of St. Michael's Hospital in Toronto looked at data from 1,265 intensive care units in hospitals in 75 countries.
It found that in one 24-hour period in 2007, more than half of the over 14,000 patients in ICUs that day had infections. Of those infected:
60 per cent had pneumonias
20 per cent were infections inside the abdomen
15 per cent were infections of the urinary tract
The longer the patients stayed in intensive care, the bigger their risk of becoming infected, the study findings suggest. The infection rate increased from 32 per cent for patients with an ICU stay of one day or less, to more than 70 per cent for patients with an ICU stay of more than seven days.
Not surprisingly, infected patients had longer ICU and hospital lengths of stay than those not infected.
Patients in ICUs who were battling infections were more than twice as likely to die than non-infected patients (25 per cent vs. 11 per cent). Their in-hospital death rate overall was also higher than non-infected patients (33 per cent vs. 15 per cent).
It's been well-documented that infections can increase the risk of death in the hospital. But the authors estimate they also account for about 40 per cent of total ICU health care costs.
"One of the things that this study actually allows us to do, is to begin to get a sense as to how much of the burden of infection is an added burden on a patient who is already at risk of dying because of the underlying diseases that led them to be in the intensive care unit," Dr. Marshall said in a statement.
Countries in Central and South America had the highest infection rates while more developed countries such as Australia and New Zealand had the lowest rates.
There are a number of things doctors could do to limit infections in hospital, write two doctors in an accompanying editorial, Dr. Steven M. Opal, of Warren Alpert Medical School of Brown University in Providence, R.I., and Dr. Thierry Calandra, of Centre Hospitalier Universitaire Vaudois and University of Lausanne in Switzerland.
Firstly, doctors should work to combat antibiotic resistance by limiting the use of antibiotics to patients who clearly have bacterial infections and then discontinue their use when their possible benefits have been obtained.
But even more important, new drugs need to be developed to replace the increasingly obsolete classes of antibiotics that currently exist, they insist.
"A 'post-antibiotic era' is difficult to contemplate but might become a reality unless the threat of progressive antibiotic resistance is taken seriously," the authors write.
