Microbial surveillance in the intensive care unit

Abstract

Nosocomial infections occur approximately three to six times more frequently in patients admitted to ICUs than in patients residing in general wards [1]. The prevalence of nosocomial infection in critically ill patients is about 20%, depending on the type of admission diagnosis and underlying conditions predisposing to microbial colonization and infection [2]. Despite all the efforts taken in infection control, the incidence of nosocomial infection in ICUs has increased over the past 3 decades. There are several reasons for this trend. Together with the widespread use of invasive techniques disrupting the host's anatomical barriers, more patients are receiving immunosuppressive therapy, decreasing humoral and cellular defense against microorganisms. And, thirdly, improved emergency and supportive care has resulted in better acute phase survival, but simultaneously has led to a growing number of long-term ICU residents. All these factors result in a pool of patients extremely vulnerable to nosocomial infection, grouped in units with a high workload and a degree of urgency which results in a suboptimal compliance with standard infection control measures. © 2007 Springer-Verlag Berlin Heidelberg.