A8. Infection and infection control on the ICU
Although intensive care units (ICUs) account for fewer than 10% of total beds in most hospitals, more than 20% of all nosocomial infections are acquired in ICUs. ICU-acquired infections account for substantial morbidity, mortality, and expense. Most bacterial infections that occur on the ICU have some sort of anti-microbial resistance.
Most common infections:
- Catheter-associated UTI
- Ventilator-associated pneumonia (VAP) – occurs > 48 hours after initiation of invasive ventilation
- Gram-negatives (pseudomonas, E. coli)
- S. aureus
- Central line-associated blood stream infection (CLABSI)
Most problematic pathogens:
- Vancomycin-resistant enterococci (VRE)
- MRSA
- Pseudomonas aeruginosa
- Multidrug-resistant gram-negative bacteria
Risk factors:
- Patients in poor condition
- Invasive interventions and devices
- Older age
- Comorbidities
- Long duration of hospitalization
- Antibiotic use
Prevention:
- Proper hygienic measures
- Ensure sterility during procedures
- Avoid invasive procedures when possible
- Discontinue indwelling sources of infection when possible
- Education of staff
- Etc.