Epidemiological survey on severe infectious diseases

The control of severe in-hospital infections still represents a unsolved problem in clinical practice. To picture the Italian situation in this field, an epidemiological survey has been undertaken in a sample of Italian hospitals. The main objectives were to describe the 'natural history' of clinically relevant infections and to compare the diagnostic and therapeutic different approaches. The study was conducted prospectively, including all patients with severe infections consecutively admitted to each participanting hospital. Clinical, microbiological and therapeutic data have been collected through a specific form. A network of 79 hospitals has been established with 141 participating wards. Data on 1159 cases of several infectious diseases were collected. The therapeutic approach was empirical in 92% of the patients, monotherapy in 43%. Cephalosporins and carbapenemics were the most frequently used drugs for monotherapy, while in the other cases several combinations were used. A favourable clinical outcome was reported over the study period for 62% of patients, with a wide variability among different types of diagnoses. The severity of the epidemiological cohort is confirmed by the high rate of in-hospital death (18%).