Prevalence rates of infection in intensive care units of a tertiary teaching hospital

objective: to determine the prevalence rates of infections among intensive care unit patients, the predominant infecting organisms, and their resistance patterns. to identify the related factors for intensive care unit-acquired infection and mortality rates. design: a 1-day point-prevalence study. setting:a total of 19 intensive care units at the hospital das clínicas - university of s？o paulo, school of medicine (hc-fmusp), a teaching and tertiary hospital, were eligible to participate in the study. patients: all patients over 16 years old occupying an intensive care unit bed over a 24-hour period. the 19 intensive care unit s provided 126 patient case reports. main outcome measures: rates of infection, antimicrobial use, microbiological isolates resistance patterns, potential related factors for intensive care unit-acquired infection, and death rates. results: a total of 126 patients were studied. eighty-seven patients (69%) received antimicrobials on the day of study, 72 (57%) for treatment, and 15 (12%) for prophylaxis. community-acquired infection occurred in 15 patients (20.8%), non- intensive care unit nosocomial infection in 24 (33.3%), and intensive care unit-acquired infection in 22 patients (30.6%). eleven patients (15.3%) had no defined type. the most frequently reported infections were respiratory (58.5%). the most frequently isolated bacteria were enterobacteriaceae (33.8%), pseudomonas aeruginosa (26.4%), and staphylococcus aureus (16.9%; [100% resistant to methicillin]). multivariate regression analysis revealed 3 risk factors for intensive care unit-acquired infection: age > 60 years (p = 0.007), use of a nasogastric tube (p = 0.017), and postoperative status (p = 0.017). at the end of 4 weeks, overall mortality was 28.8%. patients with infection had a mortality rate of 34.7%. there was no difference between mortality rates for infected and noninfected patients (p=0.088). conclusion: the rate of nosocomial infection is high in intensive care unit pa