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Vol. 35. Issue 2.
Pages 75-83 (January 2011)
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Vol. 35. Issue 2.
Pages 75-83 (January 2011)
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Microbiological profile of infections in the Intensive Care Units of Colombia (EPISEPSIS Colombia)
Perfil microbiológico de las Infecciones en Unidades de Cuidados Intensivos de Colombia (EPISEPSIS Colombia)
F.J. Molinaa,
Corresponding author

Corresponding author.
, C.A. Díazb, L. Barrerac, G. De La Rosad, R. Dennise, C. Dueñasf, M. Granadosg, D. Londoñoh, G. Ortizi, F. Rodríguezj, F. Jaimesk
a. Unidad de Terapia Intensiva, Clínica Universitaria Bolivariana, Medellín, Antioquia, Colombia
b. Universidad Pontificia Bolivariana, Medellín, Antioquia, Colombia
c. Departamentos de Medicina Interna, Hospital Universitario del Valle, Cali, Valle del Cauca, Colombia
d. Unidad de Cuidados Intensivos, Hospital Pablo Tobón Uribe, Medellín, Antioquia, Colombia
e. Departamentos de Medicina Interna y de Investigaciones, Fundación Cardioinfantil, Bogotá, Colombia
f. Universidad de Cartagena, Unidad de Cuidados Intensivos, Hospital Bocagrande y Clínica Madre Bernarda, Cartagena, Bolívar, Colombia
g. Unidad de Cuidados Intensivos, Fundación Valle del Lili, Cali, Valle del Cauca, Colombia
h. Unidad de Neumología, Hospital Universitario San Ignacio, Pontificia Universidad Javeriana, Bogotá, Colombia
i. Unidad de Cuidados Intensivos, Hospital Santa Clara, Bogotá, Colombia
j. Universidad de Antioquia, Medellín, Antioquia, Colombia
k. Universidad de Antioquia, Departamento de Medicina Interna, Hospital Universitario San Vicente de Paul, Medellín, Antioquia, Colombia
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Background and objective

Valid and reliable data regarding sepsis is lacking in Colombia. Our aim was to determine the prevalence of the microorganisms in the main infections treated in Intensive Care Units (ICUs) in our country.


This is a sub-study of a prospective cohort with 10 general hospitals in Colombia during a 6-month period. The inclusion criteria were hospitalization in ICU and confirmation of infection according to the CDC definitions. Patients were classified into three groups, that is, community, hospital and intensive care, according to the site where the infection was acquired.


A total of 826 patients were included in this analysis. Of these, 51% developed infections in the community, 5.33% in the hospital and 43.7% in intensive care unit. Overall, the most common diagnoses were pneumonia (29.54%), intra-abdominal infection (18.16%) and urinary tract infection (11.62%). The most frequent germ in community-acquired infections was E. coli −lung (16. 4%), peritoneum (57.7%), urine (55.5%), blood (22.4%)−. E. Coli−peritoneum (29.3%), urine (52.9%)− also predominated in the ICU-acquired infections, except for lung and blood in which Staphylococcus aureus (32.4%) and Klebsiella pneumoniae (15.7%) were the most prevalent. Cultures were requested from 655 patients, 40% of them having received antibiotics before cultures were taken, although this did not affected the percentages of positive cultures (P=0.583).


Pneumonia was the main cause of infection regardless of the site of acquisition. E. coli was the most prevalent germ, except in the pulmonary infections acquired in UCI in which S. aureus was the most prevalent.

Intensive care unit
Introducción y objetivo

En Colombia faltan datos fiables sobre el comportamiento de la sepsis. Se pretende determinar la prevalencia de los microorganismos en las principales infecciones tratadas en las unidades de cuidados intensivos (UCI) de nuestro país.


Este es un subestudio de una cohorte prospectiva recolectada en 10 hospitales durante 6 meses. Los criterios de inclusión eran hospitalización en UCI y confirmación de una infección según las definiciones del CDC, considerando tres grupos (comunidad, hospital, UCI) según el sitio de adquisición de la infección.


Se incluyó en el análisis a 826 pacientes; el 51% contrajeron procesos infecciosos extrahospitalarios; el 5,33%, en el hospital y el 43,7%, en UCI. Los diagnósticos más frecuentes fueron neumonía (29,54%), infección intraabdominal (18,16%) e infección del tracto urinario (11,62%). El microorganismo más frecuente en las infecciones extrahospitalarias fue Escherichia coli −pulmón (16,4%), peritoneo (57,7%), orina (55,5%) y sangre (22,4%)−. En las adquiridas en UCI predomina también E. coli −peritoneo (29,3%) y orina (52,9%)−, excepto en pulmón y sangre, en los que fueron Staphylococcus aureus (32,4%) y Klebsiella pneumoniae (15,7%) los más prevalentes. Se tomaron cultivos a 655 pacientes, de los que el 40% recibió antibióticos antes de la toma, sin que esto afectara al porcentaje de positividad (p=0,583).


La neumonía fue la infección más frecuente independientemente del sitio de adquisición. E. coli fue el patógeno más prevalente, excepto en las infecciones pulmonares adquiridas en UCI, donde lo fue S. aureus.

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R.C. Bone.
Sepsis, the sepsis syndrome, multi-organ failure: a plea for comparable definitions.
Ann Intern Med, 114 (1991), pp. 332-333
American College of Chest Physicians/Society of Critical Care Medicine Consensus Conference: definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis.
Crit Care Med, 20 (1992), pp. 864-874
G.S. Martin, D.M. Mannino, S. Eaton, M. Moss.
The epidemiology of sepsis in the United States from 1979 through 2000.
N Engl J Med, 348 (2003), pp. 1446-1454
D. Annane, P. Aegerter, M.C. Jars-Guincestre, B. Guidet.
CUB-Réa Network Current epidemiology of septic shock: The CUB-Réa Network.
Am J Respir Crit Care Med, 16 (2003), pp. 165-172
P. Eggimann, D. Pittet.
Infection control in the ICU.
Chest, 120 (2001), pp. 2059-2093
G.B. Orsi, L. Di Stefano, N. Noah.
Hospital-acquired, laboratory confirmed bloodstream infection: increased hospital stay and direct costs.
Infect Control Hosp Epidemiol, 23 (2002), pp. 190-197
G. Ducel, J. Fabry, L. Nicolle.
Prevención de las infecciones nosocomiales.
Guía Práctica, 2nd ed.,
J.L. Vincent, J. Rello, J. Marshall, E. Silva, A. Anzueto, C.D. Martin.
International study of the prevalence and outcomes of infection in intensive care units.
JAMA, 302 (2009), pp. 2323-2329
F. Jaimes.
A literature review of the epidemiology of sepsis in Latin America.
Rev Panam Salud Pública, 188 (2005), pp. 163-171
E. Silva, A. Pedro Mde, A.C. Sogayar, T. Mohovic, C.L. Silva, M. Janiszewski, et al.
Brazilian Sepsis Epidemiological Study (BASES study).
Crit Care, 8 (2004), pp. R251-R260
J.S. Garner, W.R. Jarvis, T.G. Emoris, T.C. Horan, J.M. Hughes.
CDC definitions for nosocomial infections, 1988.
Am J Infect Control, 16 (1988), pp. 128-140
W.A. Knaus, E.A. Draper, D.P. Wagner, J.E. Zimmerman.
APACHE II: A severity of disease classification system.
Crit Care Med, 13 (1985), pp. 818-829
J.L. Vicent, R. Moreno, J. Takala, F.S. Willatts, A. De Mendonça, H. Bruining, et al.
The SOFA (Sepsis-related Organ Failure Assessment) score to describe organ dysfunction/failure. On behalf of the Working Group on Sepsis-Related Problems of the European Society of Intensive Care Medicine.
Intensive Care Med, 22 (1996), pp. 707-710
S. Finder, R. Bellomo, J. Lipman, C. French, G. Dobb, J. Myburgh, et al.
Adult-population incidence of severe sepsis in Australian and New Zealand intensive care units.
Intensive Care Med, 30 (2004), pp. 589-596
D. Annane, P. Aegerter, M.C. Jars-Guincestre, B. Guidet.
CUB-Réa Network. Current epidemiology of septic shock: the CUB-Réa Network.
Am J Respir Crit Care Med, 168 (2003), pp. 165-172
M.D. Tanriover, G.S. Guven, D. Sen, S. Unal, O. Uzun.
Epidemiology and outcome of sepsis in a tertiary-care hospital in a developing country.
Epidemiol Infect, 134 (2006), pp. 315-322
C. Alberti, C. Brun-Buisson, H. Burchardi, C. Martin, S. Goodman, A. Artigas, et al.
Epidemiology of sepsis and infection in ICU patients from an international multicentre cohort study.
Intensive Care Med, 28 (2002), pp. 108-121
C. Engel, F.M. Brunkhorst, H.G. Bone, R. Brunkhorst, H. Gerlach, S. Grond, et al.
Epidemiology of sepsis in Germany: results from a national prospective multicenter study.
Intensive Care Med, 33 (2007), pp. 606-618
R. Záhorec, J. Firment, J. Straková, J. Mikula, P. Malík, F.I Novák, et al.
Epidemiology of severe sepsis in intensive care units in the Slovak Republic.
Infection, 33 (2005), pp. 122-128
D.C. Angus, W.T. Linde-Zwirble, J. Lidicker, G. Clermont, J. Carcillo, M.R. Pinsky.
Epidemiology of severe sepsis in the United States: Analysis of incidence, outcome, and associated costs of care.
Crit Care Med, 29 (2001), pp. 1303-1310
S. Karlsson, M. Varpula, E. Ruokonen, V. Pettilä, I. Parviainen, T.I. Ala-Kokko, et al.
Incidence, treatment, and outcome of severe sepsis in ICU-treated adults in Finland: the Finnsepsis study.
Intensive Care Med, 33 (2007), pp. 435-443
H. Markogiannakis, N. Pachylaki, E. Samara, M. Kalderi, M. Minettou, M. Toutouza, et al.
Infections in a surgical intensive care unit of a university hospital in Greece.
Int J Infect Dis, 13 (2009), pp. 145-153
S. Jacobson, G. Johansson, O. Winsó.
Primary sepsis in a university hospital in northern Sweden: A retrospective study.
Acta Anaesthesiol Scand, 48 (2004), pp. 960-967
J.L. Vincent, Y. Sakr, C. Sprung, V.M. Ranieri, K. Reinhart, H. Gerlach, et al.
Sepsis in European intensive care units: Results of the SOAP study.
Crit Care Med, 34 (2006), pp. 344-353
B. Khwannimit, R. Bhurayanontachai.
The epidemiology of, and risk factors for, mortality from severe sepsis and septic shock in a tertirary-care university hospital setting.
Epidemiol Infect, 137 (2009), pp. 1333-1341
B. Cheng, G. Xie, S. Yao, X. Wu, Q. Guo, M. Gu, et al.
Epidemiology of severe sepsis in critically ill surgical patients in ten university hospitals in China.
Crit Care Med, 35 (2007), pp. 2538-2546
V. Degoricija, M. Sharma, A. Legac, M. Gradiser, S. Sefer, Z. Vucicevic.
Survival analysis of 314 episodes of sepsis in Medical Intensive Care Unit in University Hospital: Impact of intensive care unit performance and antimicrobial therapy.
Croat Med J, 47 (2006), pp. 385-397
Copyright © 2011. Elsevier y Sociedad Española de Medicina Intensiva, Critica y Unidades Coronarias
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