Prevalence of infections in intensive care units in Mexico: A multicenter study

Objective: To determine the 1-day prevalence of community-acquired,hospital -acquired, or intensive care unit (ICU)-acquired infections in Mexican ICUs . To identify associated risk factors, predominant infecting organisms, and mortality rates. Design: A 1-day point-prevalence study. Setting: A total of 254 adult ICUs in Mexico. Patients: Adult patients hospitalized in the participating ICUs. Results: A total of 895 patients were studied, of whom 521 patients (58.2%) were infected. community-acquired infection occurred in 214 patients (23.9 %), non-ICU nosocomial infection occurred in 99 patients (11.1%), and 208 p atients had at least one ICU-acquired infection (23.2%; 1.45 episodes/patie nt). The most frequently reported ICU-acquired infections were pneumonia (3 9.7%), urinary tract infections (20.5%), wound infection (13.3%), and bacte remia (7.3%). The mortality rate for the ICU-acquired infections after 6 wk s of follow-up was 25.5%. Multivariate regression analysis showed the follo wing risk factors for ICU-acquired infections: neurologic failure as a prim ary cause of admission (odds ratio [OR], 1.697; 95% confidence interval [GI ], 1.001-2.839); length of stay in ICU (OR, 1.119; 95% CI, 1.091-1.151); nu mber of therapeutic and/or diagnostic interventions during the preceding we ek (OR, 1.118; 95% CI, 1.016-1.231); peripherally administered infusion of hyperosmolar solutions (OR, 6.93; 95% CI, 2.452-21.661); sedative usage in the preceding week (OR, 1.751; 95% CI, 1.183-2.602); history of an emergenc y surgery in the preceding month (OR, 1.875; 95% CI, 1.251-2.813). The admi nistration of antimicrobial treatment if there was an infection decreased t he risk of death (OR, 0.406; 95% CI, 0.204-0.755). Conclusions: Evidence of a high frequency of nosocomial infections was foun d, and potential risk factors for acquiring infections and mortality were i dentified. Mortality rates according to the hierarchy of the systemic infla mmatory response syndrome in Latin American ICUs are reported.