Death rates in the intensive care unit (ICU) as a result of bloodstream infections are significantly greater for moderately sick patients than for those who are more severely ill at the time of admission, researchers report in the American Journal of Respiratory and Critical Care Medicine.

As senior author Dr. Mary-Claire Roghmann told Reuters Health, “these infections are more common in the sickest patients and thus hospitals often provide more infection prevention in these patients. Our study suggests that this strategy may not be the best one.”

Roghmann of the VA Maryland Health Care System, Baltimore, and colleagues came to this conclusion after studying data for 2,783 ICU patients, of whom 269 developed bloodstream infections.

“We confirmed that more infections occur in the sicker patients,” continued Roghmann. “However, we found that a less ill patient who got an infection had twice the risk of dying than a similarly…ill patient who didn’t get an infection.”

In contrast, the more severely ill patient who got an infection had about the same risk of dying as the severely ill patient who didn’t get an infection, she added.

To have “the biggest impact possible on our patients’ safety,” she concluded, “we may need to provide more infection prevention in our less ill patients.”

SOURCE: American Journal of Respiratory Critical Care Medicine, March 15, 2005.