Advances in Clinical and Experimental Medicine

Title abbreviation: Adv Clin Exp Med
JCR Impact Factor (IF) – 1.736
5-Year Impact Factor – 2.135
Index Copernicus  – 168.52
MEiN – 70 pts

ISSN 1899–5276 (print)
ISSN 2451-2680 (online)
Periodicity – monthly

Download original text (EN)

Advances in Clinical and Experimental Medicine

2019, vol. 28, nr 7, July, p. 907–912

doi: 10.17219/acem/94147

Publication type: original article

Language: English

Download citation:

  • BIBTEX (JabRef, Mendeley)
  • RIS (Papers, Reference Manager, RefWorks, Zotero)

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

Dariusz Tomaszewski1,A,B,C,D,E,F, Zbigniew Rybicki1,A,B,C,E,F, Wiesława Duszyńska2,C,D,F

1 Department of Anesthesiology and Intensive Therapy, Military Institute of Medicine, Warszawa, Poland

2 Department of Anesthesiology and Intensive Care, Wrocław University Hospital, Poland


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%). Methicillin-resistant 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.
Conclusion. 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.

Key words

intensive care unit, hospital infection, one-day prevalence study

References (26)

  1. Angus DC, Linde-Zwirble WT, Lidicker J, Clermont G, Carcillo J, Pinsky MR. Epidemiology of severe sepsis in the United States: Analysis of incidence, outcome, and associated costs of care. Crit Care Med. 2001;29(7):1303–1310.
  2. Vincent JL, Sakr Y, Sprung CL, et al; Sepsis Occurrence in Acutely Ill Patients Investigators. Sepsis in European intensive care units: Results of the SOAP study. Crit Care Med. 2006;34(2):344–353.
  3. Esteban A, Frutos-Vivar F, Ferguson ND, et al. Sepsis incidence and outcome: Contrasting the intensive care unit with the hospital ward. Crit Care Med. 2007;35(5):1284–1289.
  4. Vincent JL, Bihari DJ, Suter PM, et al. The prevalence of nosocomial infection in intensive care units in Europe. Results of the European Prevalence of Infection in Intensive Care (EPIC) Study. EPIC International Advisory Committee. JAMA. 1995;274(8):639–644.
  5. Vincent JL, Rello J, Marshall J, et al; EPIC II Group of Investigators. International study of the prevalence and outcomes of infection in intensive care units. JAMA. 2009;302(21):2323–2329.
  6. Rosenthal VD, Al-Abdely HM, El-Kholy AA, et al. International Nosocomial Infection Control Consortium report, data summary of 50 countries for 2010–2015: Device-associated module. Am J Infect Control. 2016;44(12):1495–1504.
  7. Dudeck MA, Weiner LM, Allen-Bridson K, et al. National Healthcare Safety Network (NHSN) report, data summary for 2012, device-associated module. Am J Infect Control. 2013;41(12):1148–1166.
  8. European Centre for Disease Prevention and Control. Annual Epidemiological Report 2016 – Healthcare-associated infections acquired in intensive care units. (online) 2016. Accessed September 30, 2017.
  9. Horan TC, Andrus M, Dudeck MA. CDC/NHSN surveillance definition of health care-associated infection and criteria for specific types of infections in the acute care setting. Am J Infect Control. 2008;36(5): 309–332.
  10. European Committee on Antimicrobial Susceptibility Testing (EUCAST). Breakpoint tables for interpretation of MICs and zone diameters. Version 6.0.; 2016. Accessed September 30, 2017.
  11. Magill SS, Edwards JR, Bamberg W, et al; Emerging Infections Program Healthcare-Associated Infections and Antimicrobial Use Prevalence Survey Team. Multistate point-prevalence survey of health care-associated infections. N Engl J Med. 2014;370(13):1198–1208.
  12. Balkhy HH, Cunningham G, Chew FK, et al. Hospital- and community-acquired infections: A point prevalence and risk factors survey in a tertiary care center in Saudi Arabia. Int J Infect Dis. 2006;10(4):326–333.
  13. Toufen Junior C, Hovnanian AL, Franca SA, Carvalho CR. Prevalence rates of infection in intensive care units of a tertiary teaching hospital. Rev Hosp Clin Fac Med Sao Paulo. 2003;58(5):254–259.
  14. Morioka H, Hirabayashi A, Iguchi M, et al. The first point prevalence survey of health care-associated infection and antimicrobial use in a Japanese university hospital: A pilot study. Am J Infect Control. 2016;44(7):e119–e123.
  15. Esen S, Leblebicioglu H. Prevalence of nosocomial infections at intensive care units in Turkey: A multicentre 1-day point prevalence study. Scand J Infect Dis. 2004;36(2):144–148.
  16. Wójkowska-Mach J, Gryglewska B, Czekaj J, Adamski P, Grodzicki T, Heczko PB. Infection control: Point prevalence study versus incidence study in Polish long-term care facilities in 2009–2010 in the Małopolska Region. Infection. 2013;41(1):1–8.
  17. Rybicki Z, Truszczyński A, Kowalczyk W, Goraj R. Analysis of bacteria population and sensitivity to antibiotic therapy in intensive care unit patients. One-day trial. Clin Microbiol Infect. 1997;3:P336.
  18. Kübler A, Durek G, Zamirowska A, et al. Severe sepsis in Poland: Results of internet surveillance of 1043 cases. Med Sci Monit. 2004; 10(11):CR635–CR641.
  19. Zingg W, Hopkins S, Gayet-Ageron A, et al; ECDC PPS study group. Health-care-associated infections in neonates, children, and adolescents: An analysis of paediatric data from the European Centre for Disease Prevention and Control point-prevalence survey. Lancet Infect Dis. 2017;17(4):381–389.
  20. Weiner LM, Webb AK, Limbago B, et al. Antimicrobial-resistant pathogens associated with healthcare-associated infections: Summary of data reported to the National Healthcare Safety Network at the Centers for Disease Control and Prevention, 2011–2014. Infect Control Hosp Epidemiol. 2016;37(11):1288–1301.
  21. Harris KI, Perencevich EN, Rosenthal GE, Herwaldt LA. Multidrug-resistant Acinetobacter baumannii: A growing worldwide problem. Infect Dis Clin Pract (Baltim Md). 2013;21:285–288.
  22. Maraki S, Mantadakis E, Mavromanolaki VE, Kofteridis DP, Samonis G. A 5-year surveillance study on antimicrobial resistance of Acinetobacter baumannii clinical isolates from a tertiary Greek hospital. Infect Chemother. 2016;48(3):190–198.
  23. Coque TM, Baquero F, Canton R. Increasing prevalence of ESBL-producing Enterobacteriaceae in Europe. Euro Surveill. 2008;13(47). pii: 19044.
  24. Bartlett JG. Clinical practice. Antibiotic-associated diarrhea. N Engl J Med. 2002;346(5):334–339.
  25. Duszyńska W, Rosenthal VD, Dragan B, et al. Ventilator-associated pneumonia monitoring according to the INICC project at one centre. Anaesthesiol Intensive Ther. 2015;47(1):34–39.
  26. Duszyńska W, Rosenthal VD, Szczęsny A, et al. Urinary tract infections in intensive care unit patients: A single-centre, 3-year observational study according to the INICC project. Anaesthesiol Intensive Ther. 2016;48(1):1–6.