The Polish Prevalence of Infection in Intensive Care (PPIC): A one-day point prevalence multicenter study

Abstract

Background. Infections in critically ill patients are the main reasons for a lack of therapeutic success and increased mortality in intensive care units (ICUs). There have been many analyses of the incidence of infections in ICUs; however, no large studies of this kind have been conducted either in Poland or in Eastern and Central Europe. Objectives. The aim of the research was to undertake a one-day study of the prevalence of infections in ICUs in Warszawa and the Mazovian region of Poland. Material and methods. A prospective questionnaire survey analysis − a one-day prevalence study of infections − was carried out on June 25, 2014, in 28 ICUs in Poland. Results. Among 205 ICU patients (193 adults and 12 children), 134 infections were found in 101 patients (99/193 adults (51.30%) and 2/12 children (16.70%)), and bacterial colonization in 19/205 (9.3%) patients. In 66.42% of the cases, more than 1 site of infection was diagnosed. On the day of the study, 75.40% of the diagnosed infections had positive microbiological results. The most frequent were respiratory tract infections (53.73%), wound infections (18.65%) and bloodstream infections (14.92%). Most of the infections (64. 10%) were caused by Gram-negative bacteria (GN), followed by Gram-positive bacteria (GP; 31.80%) and fungi (4. 10%). The most frequently reported GN microorganisms were Enterobacteriaceae (44.7%). Methicillinresistant Staphylococcus aureus (MRSA) infections were found in 8.80% of the patients. Antibiotics were administered to 75.60% of the adult patients, in 69.20% as targeted treatment. Mechanical ventilation, central vein catheterization and urinary bladder catheterization were used in 67.80%, 85.85% and 94.63% of the patients, respectively. Conclusions. On the day of the study, more than half of the patients had infections, mostly from GN bacteria. Respiratory tract infections were the main type found. In about 2/3 of the patients, antibiotics were administered, mainly as targeted therapy.

Device associated –health care associated infections monitoring, prevention and cost assessment at intensive care unit of University Hospital in Poland (2015–2017)

“…In other Polish observational study VAP (15.5/1000) and CLA-BSI (5/1000) incidence density was higher and CAUTI (1.9/1000) incidence density was lower than in our study [34]. Results of our study were similar to results of other studies when VAP was the most commonly diagnosed DA-HAI [6,8,[10][11][12]15]. Our results showed that clinical presentations of HAIs were more frequent than those found in European Centre Disease Control report (except for CLA-BSI), more frequent than the USA CDC report, yet less frequent than in limited-resource countries (except for CA-UTI) [10,24,25].…”

“…Nevertheless, infection risk factors were also found to be present on admission [5,6]. According to published data, over 50% of ICU patients are infected [7,8]. It was also found that DA-HAIs concern about 24.3-27.6% of ICU patients [6,9].…”

“…Monitoring of hospital infections in Poland was initiated by the Polish Society of Hospital Infections in 1999 and remains effective due to their cooperation with the European Centre for Disease Prevention and Control (ECDC) [15][16][17]. Even though Poland has been developing its infection control system quickly and effectively, few data has been published in English on hospital-acquired infections in patients treated at Polish ICUs [8,9,[15][16][17].…”

Characteristics of Microbial Factors of Healthcare-Associated Infections Including Multidrug-Resistant Pathogens and Antibiotic Consumption at the University Intensive Care Unit in Poland in the Years 2011–2018

“…The results of our studies do not differ significantly from other published studies, which show that the dominant HAIs include pneumonias followed by UTI and CLA-BSI [ 3 , 25 , 26 ]. With regards to the domination of GNB in the pathogenesis of HAIs, the results of our study correspond with the results of the Polish multi-center study (PPIC), where the GNB were responsible for 64.1% of infections, while Gram-positive bacteria accounted for 31.8% of infections, with the percentage of infections caused by fungi being 4.1% [ 18 ]. They also correspond with the results of another Polish multi-center study, where GNB accounted for 69.2% of infections and Gram-positive bacteria accounted for 26.8% [ 27 ].…”

“…According to published data, in the last decade, the continuous pre-dominance of HAIs caused by strains of GNB ( A. baumannii, P. aeruginosa, K. pneumoniae ) was observed, among which the percentage of MDR bacteria was very high (in Serbia, 88.9–97%; Egypt, 42.5–92.8%; Greece, 92.9%; India, 35–68%; Poland, 98.36% ( Acinetobacter only), Italy, 66.7%; the U.S., 14.6–73.1%) [ 10 , 11 , 12 , 13 , 14 , 15 , 16 ]. During the same period, the frequency of HAIs with MRSA etiology was variable and amounted to 2.7% in Greece, 4.56% in Egypt, 10% in Poland, 13.8% in France, 25.8% in Spain, and 10.3% in Germany [ 12 , 13 , 17 , 18 , 19 ]. Microbiological analysis of infections (also called “microbiological mapping”), which is the subject of this paper, aims to evaluate the epidemiological situation in the hospital unit and is a necessary element of the proper antibiotic policy [ 20 ].…”