Nosocomial infections in the ICU

Publication date: Available online 18 December 2018Source: Anaesthesia & Intensive Care MedicineAuthor(s): Stuart Edwardson, Chris CairnsAbstractNosocomial infections are a major cause of avoidable morbidity, mortality and extended length of stay in ICU. Prevention of these infections is key. Continual surveillance, audit and hand hygiene are therefore vital. The recent introduction of ‘care bundles’ grouping best practices for care of invasive devices have proven highly successful for reducing the rates of nosocomial infection in the ICU. Despite these strategies patients in the ICU are still twice as likely to contract a nosocomial infection compared to the general hospital population. Furthermore, the microbes involved tend to be more difficult to eradicate due to increasing microbial resistance. The most common nosocomial infections contracted in critical care are ventilator-associated pneumonia, central line-associated blood stream infection and urinary catheter-related urinary tract infection. Timely recognition and management of these conditions is key to providing best care within the ICU. The focus of therapy should always be targeted to specific microbes with information guided by initial cultures and sensitivities. This, combined with regular liaison with local microbiology colleagues, will ensure the best treatment with the least risk of causing selective pressures and further multi drug resistance.
Source: Anaesthesia and intensive care medicine - Category: Anesthesiology Source Type: research