Over the past two decades there has been an overall increase in severe infection associated with the sepsis syndrome although mortality has leveled off at around 25%.1 Similarly, the microbes causing this syndrome, usually Gram positive or Gram negative bacteria, have ceased to increase in numbers in the last few years, to be joined by an increasing number of fungal infections.
Within Europe, mortality rates in ICUs are closely related to infection rates by country2 although there are some outliers such as the United Kingdom with relatively high mortality. This raises the important issue of what exactly authors mean by an ICU. It is evident that there are relatively fewer ICU beds in the United Kingdom than in many other European countries. Clearly the intensity of care within U.K. ICU beds is much higher than in many comparable countries. In the United Kingdom one is unlikely to be admitted to an ICU unless requiring ventilation whereas some other countries include postoperative, high dependency, and even coronary care beds in their definition of ICU beds.
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