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Surveillance of microbial resistance in European Intensive Care Units: a first report from the Care-ICU programme for improved infection control

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Abstract

Purpose

To report initial results from a European ICU surveillance programme focussing on antibiotic consumption, microbial resistance and infection control.

Methods

Thirty-five ICUs participated during 2005. Microbial resistance, antibiotic consumption and infection control stewardship measures were entered locally into a web-application. Results were validated locally, aggregated by project leaders and fed back to support local audit and benchmarking.

Results

Median (range) antibiotic consumption was 1,254 (range 348–4,992) DDD per 1,000 occupied bed days. The proportion of MRSA was median 11.6% (range 0–100), for ESBL phenotype of E. coli and K. pneumoniae 3.9% (0–80) and 14.3% (0–77.8) respectively, and for carbapenem-resistant P. aeruginosa 22.5% (0–100). Screening on admission for alert pathogens was commonly omitted, and there was a lack of single rooms for isolation.

Conclusions

The surveillance programme demonstrated wide variation in antibiotic consumption, microbial resistance and infection control measures. The programme may, by providing rapid access to aggregated results, promote local and regional audit and benchmarking of antibiotic use and infection control practices.

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Acknowledgments

We wish to express our gratitude to all contributors in the CareICU network (see below), Fredrik Husander for web design and Mercedes Palomar and Dominique Monnet for valuable help with design of the questionnaire. The network was funded by the European Commission Directorate General for Health and Consumer Protection (DG SANCO) through the project Improving Patient Safety in Europe (IPSE, http://ipse.univ-lyon1.fr). Funding was also received from the Swedish Institute for Infectious Disease Control (www.smittskyddsinstitutet.se). Contributors: Ante Sekulic, Kresimir Oremus, Ljiljana Betica Radic, Marina Payerl Pal, Radovan Radonic, and Smilja Kalenic in Croatia; Václav Vaniš and Vlastimil Jindrak in the Czech Republic; Paul Naaber and Piret Mitt in Estonia; Anikó Farkas, Karolina Böröcz, Andrea Kurcz, Piroska Orosi, Erzsébet Rákay and Erika Rauth in Hungary; Elizabeth Scicluna in Malta; Monica Licker in Romania; Anita Johansson, Anne-Li Öhlin Gustafsson, Hans Blomqvist, Jonas Swanberg and Margareta Lannér Sjöberg in Sweden and Cengiz Uzun, Dilek Arman, Davut Ozdemir and Murat Dizbay in Turkey.

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Authors and Affiliations

  1. Swedish Institute for Infectious Disease Control, Solna, Sweden

    Håkan Hanberger

  2. Department of Clinical Microbiology and Infectious Diseases, Gazi University School of Medicine, Ankara, Turkey

    Dilek Arman

  3. Medical Informatics, Department of Biomedical Engineering, Linköpings Universitet, Linköping, Sweden

    Hans Gill

  4. Department of Clinical Microbiology Antibiotic Centre, Na Homolce Hospital, Praha, Czech Republic

    Vlastimil Jindrák & Václav Vanis

  5. Reference Centre for Hospital Infections, Clinical Hospital Centre, Zagreb, Croatia

    Smilja Kalenic

  6. National Centre for Epidemiologia, Budapest, Hungary

    Andrea Kurcz

  7. Department of Microbiology, “Victor Babes” University of Medicine and Pharmacy, Timisoara, Romania

    Monica Licker

  8. Department of Clinical Microbiology, United Laboratories, Tartu University Clinics, Tartu, Estonia

    Paul Naaber

  9. Infection Control Unit, Mater Dei Hospital, Msida, Malta 

    Elizabeth A. Scicluna

  10. Department of Cardiovascular Anaesthesia and Intensive Care, Linköping University Hospital, Linköping, Sweden

    Sten M. Walther

  11. Division of Cardiovascular Medicine, Department of Medical and Health Sciences, Faculty of Health Sciences, Linköpings Universitet, Linköping, Sweden

    Sten M. Walther

  12. Depatment of Anaesthesia, Faculty Division Ullevaal University Hospital, Faculty of Medicine, University of Oslo, Oslo, Norway

    Sten M. Walther

  13. Division of Infectious Diseases, Institution of Clinical and Experimental Medicine, Faculty of Health Sciences, Linköpings Universitet, 581 85, Linköping, Sweden

    Håkan Hanberger

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  1. Håkan Hanberger
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Correspondence to Håkan Hanberger.

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Hanberger, H., Arman, D., Gill, H. et al. Surveillance of microbial resistance in European Intensive Care Units: a first report from the Care-ICU programme for improved infection control. Intensive Care Med 35, 91–100 (2009). https://doi.org/10.1007/s00134-008-1237-y

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  • DOI: https://doi.org/10.1007/s00134-008-1237-y

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