CoChat
Sign Up
Cited by 399Sepsis Diagnosis and TreatmentNosocomial Infections in ICUInfection Control in Healthcare

Epidemiology and burden of sepsis acquired in hospitals and intensive care units: a systematic review and meta-analysis.

Open access
Markwart, Robby, Saito, Hiroki, Harder, Thomas, Tomczyk, Sara, Cassini, Alessandro, Fleischmann-Struzek, Carolin, Reichert, Felix, Eckmanns, Tim +1 more·2020·Intensive Care Medicine
DOI 10.1007/s00134-020-06106-2PMC PMC7381455
Open this paper in CoChat — free accountOpen PDF

Abstract

PURPOSE: Sepsis is recognized as a global public health problem, but the proportion due to hospital-acquired infections remains unclear. We aimed to summarize the epidemiological evidence related to the burden of hospital-acquired (HA) and ICU-acquired (ICU-A) sepsis. METHODS: We searched MEDLINE, Embase and the Global Index Medicus from 01/2000 to 03/2018. We included studies conducted hospital-wide or in intensive care units (ICUs), including neonatal units (NICUs), with data on the incidence/prevalence of HA and ICU-A sepsis and the proportion of community and hospital/ICU origin. We did random-effects meta-analyses to obtain pooled estimates; inter-study heterogeneity and risk of bias were assessed. RESULTS: Of the 13,239 studies identified, 51 met the inclusion criteria; 22 were from low- and middle-income countries. Twenty-eight studies were conducted in ICUs, 13 in NICUs, and ten hospital-wide. The proportion of HA sepsis among all hospital-treated sepsis cases was 23.6% (95% CI 17-31.8%, range 16-36.4%). In the ICU, 24.4% (95% CI 16.7-34.2%, range 10.3-42.5%) of cases of sepsis with organ dysfunction were acquired during ICU stay and 48.7% (95% CI 38.3-59.3%, range 18.7-69.4%) had a hospital origin. The pooled hospital incidence of HA sepsis with organ dysfunction per 1000 patients was 9.3 (95% CI 7.3-11.9, range 2-20.6)). In the ICU, the pooled incidence of HA sepsis with organ dysfunction per 1000 patients was 56.5 (95% CI 35-90.2, range 9.2-254.4) and it was particularly high in NICUs. Mortality of ICU patients with HA sepsis with organ dysfunction was 52.3% (95% CI 43.4-61.1%, range 30.1-64.6%). There was a significant inter-study heterogeneity. Risk of bias was low to moderate in ICU-based studies and moderate to high in hospital-wide and NICU studies. CONCLUSION: HA sepsis is of major public health importance, and the burden is particularly high in ICUs. There is an urgent need to improve the implementation of global and local infection prevention and management strategies to reduce its high burden among hospitalized patients.

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.1007/s00134-020-06106-2

Cites

4 of 4 references verified0 citation errors · 0 not checkable

Statistics

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • Prior sepsis research has suggested physiologic and epidemiologic heterogeneity between community-acquired and hospital-acquired sepsis populations.

    “Prior sepsis research has suggested physiologic and epidemiologic heterogeneity between community-acquired and hospital-acquired sepsis populations30”

    From Multicenter Prospective Validation of an Updated Proprietary Sepsis Prediction Model (2026) · cites this paper as [30]

    The Introduction distinguishes community-acquired from hospital-acquired sepsis, and the Discussion reports that patients with hospital-acquired sepsis have longer hospital or ICU stays than patients with community-acquired sepsis. This supports a difference between the populations, but the passages do not establish physiologic heterogeneity between them; the reported inter-study heterogeneity concerns variation across studies, not that comparison. Page numbers were not available in our copy. (LLM, conf=0.86)

    Experimental — accuracy not yet measured

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Cites

Flagged first, then by citations

Research works printed but not linked: 85

  1. [1]Singer M Deutschman CS Seymour CW Shankar-Hari M Annane D Bauer M Bellomo R Bernard GR Chiche JD Coopersmith CM Hotchkiss RS Levy MM Marshall JC Martin GS Opal SM Rubenfeld GD van der Poll T Vincent JL Angus DC The third international consensus definitions for sepsis and septic shock (Sepsis-3) JAMA 2016 315 8 801 810 10.1001/jama.2016.0287 26903338 PMC4968574 · DOI · Paper page
  2. [2]Reinhart K Daniels R Kissoon N Machado FR Schachter RD Finfer S recognizing sepsis as a global health priority—a WHO resolution N Engl J Med 2017 377 5 414 417 10.1056/NEJMp1707170 28658587 · DOI
  3. [3]Rudd KE Johnson SC Agesa KM Shackelford KA Tsoi D Kievlan DR Colombara DV Ikuta KS Kissoon N Finfer S Fleischmann-Struzek C Machado FR Reinhart KK Rowan K Seymour CW Watson RS West TE Marinho F Hay SI Lozano R Lopez AD Angus DC Murray CJL Naghavi M Global, regional, and national sepsis incidence and mortality, 1990–2017: analysis for the Global Burden of Disease Study The Lancet 2020 395 10219 200 211 10.1016/S0140-6736(19)32989-7 PMC6970225 31954465 · DOI · Paper page
  4. [4]Fleischmann C Scherag A Adhikari NK Hartog CS Tsaganos T Schlattmann P Angus DC Reinhart K Assessment of global incidence and mortality of hospital-treated sepsis. Current estimates and limitations Am J Respir Crit Care Med 2016 193 3 259 272 10.1164/rccm.201504-0781oc 26414292 · DOI · Paper page
  5. [5]Sakr Y Jaschinski U Wittebole X Szakmany T Lipman J Namendys-Silva SA Martin-Loeches I Leone M Lupu MN Vincent JL Sepsis in intensive care unit patients: worldwide data from the intensive care over nations audit Open Forum Infect Dis 2018 5 12 ofy313 10.1093/ofid/ofy313 30555852 PMC6289022 · DOI
  6. [6]Rhee C Dantes R Epstein L Murphy DJ Seymour CW Iwashyna TJ Kadri SS Angus DC Danner RL Fiore AE Jernigan JA Martin GS Septimus E Warren DK Karcz A Chan C Menchaca JT Wang R Gruber S Klompas M Incidence and trends of sepsis in US hospitals using clinical vs claims data, 2009–2014 JAMA 2017 318 13 1241 1249 10.1001/jama.2017.13836 28903154 PMC5710396 · DOI · Paper page
  7. [7]Fleischmann-Struzek C Goldfarb DM Schlattmann P Schlapbach LJ Reinhart K Kissoon N The global burden of paediatric and neonatal sepsis: a systematic review Lancet Respir Med 2018 6 3 223 230 10.1016/s2213-2600(18)30063-8 29508706 · DOI
  8. [8]Saito H Kilpatrick C Pittet D The 2018 World Health Organization SAVE LIVES: clean your hands campaign targets sepsis in health care Intensive Care Med 2018 44 4 499 501 10.1007/s00134-018-5097-9 29500700 PMC5924658 · DOI
  9. [10]Suetens C Latour K Karki T Ricchizzi E Kinross P Moro ML Jans B Hopkins S Hansen S Lyytikainen O Reilly J Deptula A Zingg W Plachouras D Monnet DL Prevalence of healthcare-associated infections, estimated incidence and composite antimicrobial resistance index in acute care hospitals and long-term care facilities: results from two European point prevalence surveys, 2016 to 2017 Eurosurveillance 2018 10.2807/1560-7917.es.2018.23.46.1800516 30458912 PMC6247459 · DOI
  10. [11]Magill SS O’Leary E Janelle SJ Thompson DL Dumyati G Nadle J Wilson LE Kainer MA Lynfield R Greissman S Ray SM Beldavs Z Gross C Bamberg W Sievers M Concannon C Buhr N Warnke L Maloney M Ocampo V Brooks J Oyewumi T Sharmin S Richards K Rainbow J Samper M Hancock EB Leaptrot D Scalise E Badrun F Phelps R Edwards JR Changes in prevalence of health care-associated infections in U.S. Hospitals N Engl J Med 2018 379 18 1732 1744 10.1056/nejmoa1801550 30380384 PMC7978499 · DOI · Paper page
  11. [12]Machado FR Cavalcanti AB Bozza FA Ferreira EM Angotti Carrara FS Sousa JL Caixeta N Salomao R Angus DC Pontes Azevedo LC The epidemiology of sepsis in Brazilian intensive care units (the Sepsis PREvalence Assessment Database, SPREAD): an observational study Lancet Infect Dis 2017 17 11 1180 1189 10.1016/s1473-3099(17)30322-5 28826588 · DOI · Paper page
  12. [13]Schreiber PW Sax H Wolfensberger A Clack L Kuster SP The preventable proportion of healthcare-associated infections 2005–2016: systematic review and meta-analysis Infect Control Hosp Epidemiol 2018 39 11 1277 1295 10.1017/ice.2018.183 30234463 · DOI
  13. [15]Bone RC Balk RA Cerra FB Dellinger RP Fein AM Knaus WA Schein RM Sibbald WJ Definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis. The ACCP/SCCM Consensus Conference Committee. American College of Chest Physicians/Society of Critical Care Medicine Chest 1992 101 6 1644 1655 10.1378/chest.101.6.1644 1303622 · DOI
  14. [16]Levy MM Fink MP Marshall JC Abraham E Angus D Cook D Cohen J Opal SM Vincent JL Ramsay G 2001 SCCM/ESICM/ACCP/ATS/sis international sepsis definitions conference Crit Care Med 2003 31 4 1250 1256 10.1097/01.ccm.0000050454.01978.3b 12682500 · DOI
  15. [17]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 10.1097/00003246-200107000-00002 11445675 · DOI · Paper page
  16. [19]Garner JS Jarvis WR Emori TG Horan TC Hughes JM CDC definitions for nosocomial infections Am J Infect Control 1988 16 3 128 140 10.1016/0196-6553(88)90053-3 2841893 · DOI
  17. [21]Hoy D Brooks P Woolf A Blyth F March L Bain C Baker P Smith E Buchbinder R Assessing risk of bias in prevalence studies: modification of an existing tool and evidence of interrater agreement J Clin Epidemiol 2012 65 9 934 939 10.1016/j.jclinepi.2011.11.014 22742910 · DOI · Paper page
  18. [22]Spencer FA Iorio A You J Murad MH Schunemann HJ Vandvik PO Crowther MA Pottie K Lang ES Meerpohl JJ Falck-Ytter Y Alonso-Coello P Guyatt GH Uncertainties in baseline risk estimates and confidence in treatment effects BMJ 2012 345 e7401 10.1136/bmj.e7401 23152569 · DOI
  19. [23]Angkasekwinai N Rattanaumpawan P Thamlikitkul V Epidemiology of sepsis in Siriraj Hospital 2007 J Med Assoc Thail 2009 92 Suppl 2 S68 S78 19562989
  20. [24]Esteban A Frutos-Vivar F Ferguson ND Penuelas O Lorente JA Gordo F Honrubia T Algora A Bustos A Garcia G Diaz-Reganon IR de Luna RR Sepsis incidence and outcome: contrasting the intensive care unit with the hospital ward Crit Care Med 2007 35 5 1284 1289 10.1097/01.ccm.0000260960.94300.de 17414725 · DOI
  21. [25]Hagel S Ludewig K Frosinski J Hutagalung R Porzelius C Gastmeier P Harbarth S Pletz MW Brunkhorst FM Effectiveness of a hospital-wide educational programme for infection control to reduce the rate of health-care associated infections and related sepsis (ALERTS)—methods and interim results Dtsch Med Wochenschr 1946 138 34–35 1717 1722 10.1055/s-0033-1349481 23934590 · DOI
  22. [26]Jones SL Ashton CM Kiehne LB Nicolas JC Rose AL Shirkey BA Masud F Wray NP Outcomes and resource use of sepsis-associated stays by presence on admission, Severity, and hospital type Med Care 2016 54 3 303 310 10.1097/mlr.0000000000000481 26759980 PMC4751740 · DOI
  23. [28]Padro T Smotherman C Gautam S Gerdik C Fultz C Lester D Guirgis F Hospital-acquired sepsis: a descriptive study and comparison to communityacquired sepsis Crit Care Med 2018 46 1 10.1097/01.ccm.0000528061.37975.c3 · DOI
  24. [29]Page DB Donnelly JP Wang HE Community-, healthcare-, and hospital-acquired severe sepsis hospitalizations in the university healthsystem consortium Crit Care Med 2015 43 9 1945 1951 10.1097/ccm.0000000000001164 26110490 PMC4537676 · DOI · Paper page
  25. [30]Rodriguez F Barrera L De La Rosa G Dennis R Duenas C Granados M Londono D Molina F Ortiz G Jaimes F The epidemiology of sepsis in Colombia: a prospective multicenter cohort study in ten university hospitals Crit Care Med 2011 39 7 1675 1682 10.1097/CCM.0b013e318218a35e 21685740 · DOI
  26. [31]Zhou J Tian H Du X Xi X An Y Duan M Weng L Du B Population-based epidemiology of sepsis in a subdistrict of Beijing Crit Care Med 2017 45 7 1168 1176 10.1097/ccm.0000000000002414 28422777 · DOI
  27. [32]Adrie C Alberti C Chaix-Couturier C Azoulay E De Lassence A Cohen Y Meshaka P Cheval C Thuong M Troche G Garrouste-Orgeas M Timsit JF Epidemiology and economic evaluation of severe sepsis in France: age, severity, infection site, and place of acquisition (community, hospital, or intensive care unit) as determinants of workload and cost J Crit Care 2005 20 1 46 58 10.1016/j.jcrc.2004.10.005 16015516 · DOI
  28. [33]Baharoon S Telmesani A Tamim H Alsafi E Aljohani S Mahmoud E Al-Jahdali H Community- versus nosocomial-acquired severe sepsis and septic shock in patients admitted to a tertiary intensive care in Saudi Arabia, etiology and outcome J Infect Public Health 2015 8 5 418 424 10.1016/j.jiph.2014.12.003 25952595 · DOI
  29. [34]Beovic B Hladnik Z Pozenel P Siuka D Epidemiology of severe sepsis in Slovenian intensive care units for adults J Chemother (Florence, Italy) 2008 20 1 134 136 10.1179/joc.2008.20.1.134 18343757 · DOI
  30. [35]Blanco J Muriel-Bombin A Sagredo V Taboada F Gandia F Tamayo L Collado J Garcia-Labattut A Carriedo D Valledor M De Frutos M Lopez MJ Caballero A Guerra J Alvarez B Mayo A Villar J Incidence, organ dysfunction and mortality in severe sepsis: a Spanish multicentre study Crit Care (London, England) 2008 12 6 R158 10.1186/cc7157 PMC2646323 19091069 · DOI
  31. [36]Carvajal-Estupiñán JFN-JF Ospina-Díaz JM Characterizing patients with diagnosis of sepsis in an intensive care unit, at Bucaramanga, Colombia 2010–2011 Arch Med (Manizales) 2016 16 1 53 10.30554/archmed.16.1.1538.2016 · DOI
  32. [37]Cheng B Xie G Yao S Wu X Guo Q Gu M Fang Q Xu Q Wang D Jin Y Yuan S Wang J Du Z Sun Y Fang X Epidemiology of severe sepsis in critically ill surgical patients in ten university hospitals in China Crit Care Med 2007 35 11 2538 2546 10.1097/01.ccm.0000284492.30800.00 17828034 · DOI
  33. [38]Dabar G Harmouche C Salameh P Jaber BL Jamaleddine G Waked M Yazbeck P Community- and healthcare-associated infections in critically ill patients: a multicenter cohort study Int J Infect Dis 2015 37 80 85 10.1016/j.ijid.2015.05.024 26051976 · DOI
  34. [39]Dougnac AL Mercado MF Cornejo RR Cariaga MV Hernandez GP Andresen MH Bugedo GT Castillo LF Prevalence of severe sepsis in intensive care units. A national multicentric study Rev Med Chil 2007 135 5 620 630 10.4067/s0034-98872007000500010 17657331 · DOI
  35. [40]Gasparovic V Gornik I Ivanovic D Sepsis syndrome in Croatian intensive care units: piloting a national comparative clinical database Croat Med J 2006 47 3 404 409 16758518 PMC2080430
  36. [41]SepNet Critical Care Trials Group Incidence of severe sepsis and septic shock in German intensive care units: the prospective, multicentre INSEP study Intensive Care Med 2016 42 12 1980 1989 10.1007/s00134-016-4504-3 27686355 · DOI
  37. [42]The Irish Critical Care Trials Group Intensive care for the adult population in Ireland: a multicentre study of intensive care population demographics Crit Care (London, England) 2008 12 5 R121 10.1186/cc7018 PMC2592752 18801161 · DOI
  38. [44]Karlsson S Varpula M Ruokonen E Pettila V Parviainen I Ala-Kokko TI Kolho E Rintala EM Incidence, treatment, and outcome of severe sepsis in ICU-treated adults in Finland: the Finnsepsis study Intensive Care Med 2007 33 3 435 443 10.1007/s00134-006-0504-z 17225161 · DOI
  39. [45]Kubler A Adamik B Durek G Mayzner-Zawadzka E Gaszynski W Karpel E Duszynska W Results of the severe sepsis registry in intensive care units in Poland from 2003–2009 Anaesthesiol Intensive Ther 2015 47 1 7 13 10.5603/ait.2015.0002 25751289 · DOI
  40. [46]Levy MM Artigas A Phillips GS Rhodes A Beale R Osborn T Vincent JL Townsend S Lemeshow S Dellinger RP Outcomes of the surviving sepsis campaign in intensive care units in the USA and Europe: a prospective cohort study Lancet Infect Dis 2012 12 12 919 924 10.1016/s1473-3099(12)70239-6 23103175 · DOI
  41. [47]Malacarne P Langer M Nascimben E Moro ML Giudici D Lampati L Bertolini G Building a continuous multicenter infection surveillance system in the intensive care unit: findings from the initial data set of 9,493 patients from 71 Italian intensive care units Crit Care Med 2008 36 4 1105 1113 10.1097/CCM.0b013e318169ed30 18379234 · DOI
  42. [48]Martin CM Priestap F Fisher H Fowler RA Heyland DK Keenan SP Longo CJ Morrison T Bentley D Antman N A prospective, observational registry of patients with severe sepsis: the Canadian Sepsis treatment and response registry Crit Care Med 2009 37 1 81 88 10.1097/CCM.0b013e31819285f0 19050636 · DOI
  43. [49]Ortiz G Duenas C Rodriguez F Barrera L de La Rosa G Dennis R Granados M Londono D Molina F Jaimes F Epidemiology of sepsis in Colombian intensive care units Biomedica: revista del Instituto Nacional de Salud 2014 34 1 40 47 10.1590/s0120-41572014000100007 24967858 · DOI
  44. [50]Quenot JP Pavon A Binquet C Kara F Martinet O Ganster F Navellou JC Castelain V Barraud D Cousson J Poussel JF Perez P Kuteifan K Noirot A Predictive and prognostic factors of septic shock of nosocomial origin Crit Care 2012 16 P49 10.1186/cc10656 · DOI
  45. [51]Sakr Y Elia C Mascia L Barberis B Cardellino S Livigni S Fiore G Filippini C Ranieri VM Epidemiology and outcome of sepsis syndromes in Italian ICUs: a muticentre, observational cohort study in the region of Piedmont Minerva Anestesiol 2013 79 9 993 1002 23811620
  46. [52]Shime N Kawasaki T Saito O Akamine Y Toda Y Takeuchi M Sugimura H Sakurai Y Iijima M Ueta I Shimizu N Nakagawa S Incidence and risk factors for mortality in paediatric severe sepsis: results from the national paediatric intensive care registry in Japan Intensive Care Med 2012 38 7 1191 1197 10.1007/s00134-012-2550-z 22527068 · DOI
  47. [53]Suka M Yoshida K Takezawa J Incidence and outcome of sepsis in Japanese intensive care units: the Japanese nosocomial infection surveillance system Environ Health Prev Med 2006 11 6 298 303 10.1007/bf02898020 21432359 PMC2723455 · DOI
  48. [54]Vesteinsdottir E Karason S Sigurdsson SE Gottfredsson M Sigurdsson GH Severe sepsis and septic shock: a prospective population-based study in Icelandic intensive care units Acta Anaesthesiol Scand 2011 55 6 722 731 10.1111/j.1399-6576.2011.02437.x 21480832 · DOI
  49. [55]Vila Perez D Jordan I Esteban E Garcia-Soler P Murga V Bonil V Ortiz I Flores C Bustinza A Cambra FJ Prognostic factors in pediatric sepsis study, from the Spanish Society of Pediatric Intensive Care Pediatr Infect Dis J 2014 33 2 152 157 10.1097/01.inf.0000435502.36996.72 24413407 · DOI
  50. [57]Zahorec R Firment J Strakova J Mikula J Malik P Novak I Zeman J Chlebo P Epidemiology of severe sepsis in intensive care units in the Slovak Republic Infection 2005 33 3 122 128 10.1007/s15010-005-4019-2 15940412 · DOI
  51. [58]Zhou J Qian C Zhao M Yu X Kang Y Ma X Ai Y Xu Y Liu D An Y Wu D Sun R Li S Hu Z Cao X Zhou F Jiang L Lin J Mao E Qin T He Z Zhou L Du B Epidemiology and outcome of severe sepsis and septic shock in intensive care units in mainland China PLoS ONE 2014 9 9 e107181 10.1371/journal.pone.0107181 25226033 PMC4167333 · DOI
  52. [59]Bas AY Demirel N Zenciroglu A Gol N Tanir G Nosocomial blood stream infections in a neonatal intensive care unit in Ankara, Turkey Turk J Pediatr 2010 52 5 464 470 21434530
  53. [60]Crivaro V Bogdanovic L Bagattini M Iula VD Catania M Raimondi F Triassi M Zarrilli R Surveillance of healthcare-associated infections in a neonatal intensive care unit in Italy during 2006–2010 BMC Infect Dis 2015 15 152 10.1186/s12879-015-0909-9 25885702 PMC4374496 · DOI
  54. [61]Djordjevic ZM Markovic-Denic L Folic MM Igrutinovic Z Jankovic SM Health care-acquired infections in neonatal intensive care units: risk factors and etiology Am J Infect Control 2015 43 1 86 88 10.1016/j.ajic.2014.10.005 25564130 · DOI
  55. [62]Kamath S Mallaya S Shenoy S Nosocomial infections in neonatal intensive care units: profile, risk factor assessment and antibiogram Indian J Pediatr 2010 77 1 37 39 10.1007/s12098-010-0005-5 20135266 · DOI
  56. [63]Malla K Malla T Rao K Bacteriological profile of sepsis outbreak in the NICU of a tertiary care hospital in western Nepal J Nepal Paediatr Soc 2013 10.3126/jnps.v33i1.7016 · DOI
  57. [64]Mohammed D El Seifi OS Bacterial nosocomial infections in neonatal intensive care unit, Zagazig University Hospital, Egypt Egyptian Pediatr Assoc Gazette 2014 62 3 72 79 10.1016/j.epag.2014.10.001 · DOI
  58. [65]Molina-Cabrillana J Santana-Reyes C Hernandez J Lopez I Dorta E Incidence of nosocomial infections at a neonatal intensive care unit: a six-year surveillance study Enferm Infecc Microbiol Clin 2006 24 5 307 312 10.1157/13089665 16762256 · DOI
  59. [66]Romanelli RM Anchieta LM Mourao MV Campos FA Loyola FC Jesus LA Armond GA Clemente WT Notification of healthcare associated infections based on international criteria performed in a reference neonatal progressive care unity in Belo Horizonte, MG Revista brasileira de epidemiologia 2013 16 1 77 86 10.1590/S1415-790X2013000100008 23681325 · DOI
  60. [67]Sarvikivi E Karki T Lyytikainen O Repeated prevalence surveys of healthcare-associated infections in Finnish neonatal intensive care units J Hosp Infect 2010 76 2 156 160 10.1016/j.jhin.2010.03.020 20579770 · DOI
  61. [69]Su BH Hsieh HY Chiu HY Lin HC Lin HC Nosocomial infection in a neonatal intensive care unit: a prospective study in Taiwan Am J Infect Control 2007 35 3 190 195 10.1016/j.ajic.2006.07.004 17433943 · DOI
  62. [70]Tavora AC Castro AB Militao MA Girao JE Ribeiro Kde C Tavora LG Risk factors for nosocomial infection in a Brazilian neonatal intensive care unit Braz J Infect Dis 2008 12 1 75 79 10.1590/s1413-86702008000100016 18553019 · DOI
  63. [71]Trapani A Dalbo K Da Silva R Sakae T Silveira S Feuerschuette O Incidence and epidemiology of nosocomial infection in a neonatal intensive care unit in southern Brazil J. Perinat. Med. 2013 10.1515/jpm-2013-2003 · DOI
  64. [73]Goldstein B Giroir B Randolph A International pediatric sepsis consensus conference: definitions for sepsis and organ dysfunction in pediatrics Pediatr Crit Care Med 2005 6 1 2 8 10.1097/01.pcc.0000149131.72248.e6 15636651 · DOI
  65. [75]Irish Critical Care Trials Group Intensive care for the adult population in Ireland: a multicentre study of intensive care population demographics Crit Care 2008 12 5 R121 10.1186/cc7018 18801161 PMC2592752 · DOI
  66. [76]Agodi A Barchitta M Auxilia F Brusaferro S D’Errico MM Montagna MT Pasquarella C Tardivo S Arrigoni C Fabiani L Laurenti P Mattaliano AR Orsi GB Squeri R Torregrossa MV Mura I Epidemiology of intensive care unit-acquired sepsis in Italy: results of the SPIN-UTI network Annali di igiene: medicina preventiva e di comunita 2018 30 5 Supple 2 15 21 10.7416/ai.2018.2247 30374508 · DOI
  67. [77]Vincent J-L Marshall J Ñamendys-Silva S François B Martin-Loeches I Lipman J Reinhart K Antonelli M Pickkers P Njimi H Jimenez E Sakr Y Tomas E Bibonge E Charra B Faroudy M Doedens L Farina Z Adler D Brealey D Assessment of the worldwide burden of critical illness: the Intensive Care Over Nations (ICON) audit Lancet Respir Med 2014 10.1016/S2213-2600(14)70061-X 24740011 · DOI
  68. [78]Kilpatrick C Saito H Allegranzi B Pittet D Preventing sepsis in health care—It’s in your hands: a World Health Organization call to action J Infect Prev 2018 19 3 104 106 10.1177/1757177418769146 29796091 PMC5956707 · DOI
  69. [79]Pittet D Allegranzi B Preventing sepsis in healthcare—200 years after the birth of Ignaz Semmelweis Eurosurveillance 2018 10.2807/1560-7917.es.2018.23.18.18-00222 29741152 PMC6053623 · DOI
  70. [81]Alvarez-Moreno CA Valderrama-Beltran SL Rosenthal VD Mojica-Carreno BE Valderrama-Marquez IA Matta-Cortes L Gualtero-Trujillo SM Rodriguez-Pena J Linares-Miranda CJ Gonzalez-Rubio AP Vega-Galvis MC Riano-Forero I Ariza-Ayala BE Garcia-Laverde G Susmann O Mancera-Paez O Olarte N Rendon-Campo LF Astudillo Y Trullo-Escobar MD Orellano PW Multicenter study in Colombia: impact of a multidimensional International Nosocomial Infection Control Consortium (INICC) approach on central line-associated bloodstream infection rates Am J Infect Control 2016 44 11 e235 e241 10.1016/j.ajic.2016.03.043 27317408 · DOI
  71. [82]Rosenthal VD Ramachandran B Villamil-Gomez W Armas-Ruiz A Navoa-Ng JA Matta-Cortes L Pawar M Nevzat-Yalcin A Rodriguez-Ferrer M Yildizdas RD Menco A Campuzano R Villanueva VD Rendon-Campo LF Gupta A Turhan O Barahona-Guzman N Horoz OO Arrieta P Brito JM Tolentino MC Astudillo Y Saini N Gunay N Sarmiento-Villa G Gumus E Lagares-Guzman A Dursun O Impact of a multidimensional infection control strategy on central line-associated bloodstream infection rates in pediatric intensive care units of five developing countries: findings of the International Nosocomial Infection Control Consortium (INICC) Infection 2012 40 4 415 423 10.1007/s15010-012-0246-5 22371234 · DOI
  72. [83]Storr J Twyman A Zingg W Damani N Kilpatrick C Reilly J Price L Egger M Grayson ML Kelley E Allegranzi B Core components for effective infection prevention and control programmes: new WHO evidence-based recommendations Antimicrob Resist Infect Control 2017 6 6 10.1186/s13756-016-0149-9 28078082 PMC5223492 · DOI
  73. [84]Price L MacDonald J Melone L Howe T Flowers P Currie K Curran E Ness V Waddell D Manoukian S McFarland A Kilpatrick C Storr J Twyman A Allegranzi B Reilly J Effectiveness of national and subnational infection prevention and control interventions in high-income and upper-middle-income countries: a systematic review Lancet Infect Dis 2018 18 5 e159 e171 10.1016/s1473-3099(17)30479-6 29100898 · DOI
  74. [85]Hagel S Ludewig K Pletz MW Frosinski J Moeser A Wolkewitz M Gastmeier P Harbarth S Brunkhorst FM Kesselmeier M Scherag A Effectiveness of a hospital-wide infection control programme on the incidence of healthcare-associated infections and associated severe sepsis and septic shock: a prospective interventional study Clin Microbiol Infect 2019 25 4 462 468 10.1016/j.cmi.2018.07.010 30036671 · DOI
  75. [87]Cassini A Plachouras D Eckmanns T Abu Sin M Blank HP Ducomble T Haller S Harder T Klingeberg A Sixtensson M Velasco E Weiss B Kramarz P Monnet DL Kretzschmar ME Suetens C Burden of six healthcare-associated infections on European population health: estimating incidence-based disability-adjusted life years through a population prevalence-based modelling study PLoS Med 2016 13 10 e1002150 10.1371/journal.pmed.1002150 27755545 PMC5068791 · DOI
  76. [88]Tacconelli E Pezzani MD Public health burden of antimicrobial resistance in Europe Lancet Infect Dis 2019 19 1 4 6 10.1016/s1473-3099(18)30648-0 30409682 · DOI
  77. [89]Cassini A Hogberg LD Plachouras D Quattrocchi A Hoxha A Simonsen GS Colomb-Cotinat M Kretzschmar ME Devleesschauwer B Cecchini M Ouakrim DA Oliveira TC Struelens MJ Suetens C Monnet DL Attributable deaths and disability-adjusted life-years caused by infections with antibiotic-resistant bacteria in the EU and the European Economic Area in 2015: a population-level modelling analysis Lancet Infect Dis 2019 19 1 56 66 10.1016/s1473-3099(18)30605-4 30409683 PMC6300481 · DOI
  78. [91]Turnidge J Impact of antibiotic resistance on the treatment of sepsis Scand J Infect Dis 2003 35 9 677 682 10.1080/00365540310015953 14620154 · DOI
  79. [93]Johnson AEW Aboab J Raffa JD Pollard TJ Deliberato RO Celi LA Stone DJ A comparative analysis of sepsis identification methods in an electronic database Crit Care Med 2018 46 4 494 499 10.1097/ccm.0000000000002965 29303796 PMC5851804 · DOI
  80. [94]Mariansdatter SE Eiset AH Sogaard KK Christiansen CF Differences in reported sepsis incidence according to study design: a literature review BMC Med Res Methodol 2016 16 1 137 10.1186/s12874-016-0237-9 27733132 PMC5062833 · DOI
  81. [95]Schlapbach LJ Kissoon N Defining pediatric sepsis JAMA Pediatr 2018 172 4 312 314 10.1001/jamapediatrics.2017.5208 29459982 · DOI
  82. [96]Lee SH Hsu TC Lee MG Chao CC Lee WC Lai CC Lee CC Nationwide trend of sepsis: a comparison among octogenarians, elderly, and young adults Crit Care Med 2018 46 6 926 934 10.1097/ccm.0000000000003085 29533311 · DOI
  83. [97]Esper AM Moss M Lewis CA Nisbet R Mannino DM Martin GS The role of infection and comorbidity: factors that influence disparities in sepsis Crit Care Med 2006 34 10 2576 2582 10.1097/01.ccm.0000239114.50519.0e 16915108 PMC3926300 · DOI
  84. [98]Russo PL Stewardson AJ Cheng AC Bucknall T Mitchell BG The prevalence of healthcare associated infections among adult inpatients at nineteen large Australian acute-care public hospitals: a point prevalence survey Antimicrob Resist Infect Control 2019 8 114 10.1186/s13756-019-0570-y 31338161 PMC6628491 · DOI
  85. [99]ESICM LIVES 2019 Berlin, Germany. 28 September–2 October 2019 (2019) Intensive care medicine experimental 7(Suppl 3):55. 10.1186/s40635-019-0265-y PMC6763544 31559498 · DOI

Cited by

Sorted by citations

Authors
Markwart, R., Saito, H., Harder, T., Tomczyk, S., Cassini, A., Fleischmann-Struzek, C., Reichert, F., Eckmanns, T., & Allegranzi, B.
Affiliations
  • Robert Koch Institute (DE)
  • St. Marianna University School of Medicine (JP)
  • World Health Organization (CH)
  • Jena University Hospital (DE)
Corresponding author
Allegranzi, Benedetta
ORCID
Venue
Intensive Care Medicine
Publisher
Springer Science and Business Media LLC
Published
2020-06-26
Volume
46
Issue
8
Pages
1536-1551
ISSN
  • 0342-4642 (ISSN-L)
  • 1432-1238
DOI
10.1007/s00134-020-06106-2
PMC
PMC7381455
OpenAlex
W3037549222
Cited by
399
References
4
Citations by year
2026: 55 · 2025: 92 · 2024: 92 · 2023: 67 · 2022: 63 · 2021: 28 · 2020: 2
FWCI
5.84
Type
journal article
Language
en
Open access
Licence
Locations
  • Intensive Care Medicine (publishedVersion, cc-by-nc)
  • PubMed Central (publishedVersion, cc-by-nc)
  • PubMed (publishedVersion)
  • Publication server of the Robert Koch Institute (Robert Kock Institute) (submittedVersion, cc-by-nc)
Funders
World Health Organization
Topics
  • Health Sciences › Medicine › Epidemiology › Sepsis Diagnosis and Treatment
  • Health Sciences › Medicine › Critical Care and Intensive Care Medicine › Nosocomial Infections in ICU
  • Health Sciences › Medicine › Infectious Diseases › Infection Control in Healthcare
Keywords
hospital-acquired sepsis, nosocomial infections, sepsis incidence, sepsis mortality, organ dysfunction, intensive care unit, neonatal intensive care unit, community-acquired sepsis, low- and middle-income countries, sepsis risk factors, sepsis surveillance
MeSH terms
Cross Infection, Hospitals, Humans, Intensive Care Units, Length of Stay, Incidence, Hospital Mortality, Sepsis

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review