Infections in critically ill patients: experience in MICU at a major teaching hospital.

During a one-year period 105 patients suffering a total of 134 infectious episodes were studied prospectively in the medical intensive care unit (MICU). These patients included 54 male and 51 female patients, age ranging from 14 to 100 years (median = 54 years). The overall incidence of infection was 46.7%. Infections acquired in medical wards accounted for 47.8% of the total, followed by community-acquired infections in 27.0%, and MICU-acquired infections in 25.2% of the cases. The most frequent infections were pneumonia and septicaemia accounting for 88% of the total, whereas urinary tract (4.4%), gastrointestinal tract (5.0%), skin and wound infections (2.5%) constituted only 11.5%. The pathogens mainly involved were gram-negative rods, Staphylococcus spp. and Streptococcus pneumoniae. However, in community-acquired pneumonia, the major pathogens were gram-negative rods. In addition, Mycobacterium tuberculosis was an important cause of pneumonia in these patients. The majority of patients had a monoinfection; multiple pathogens were isolated in 11.9% of the episodes. The overall mortality was 46.7%. Several factors that influenced the mortality in these patients were analyzed. Early recognition of these factors may reduce morbidity and mortality.