Infection control in the intensive care unit

Abstract

Intensive care unit (ICU)-acquired infections are a major cause of morbidity and mortality associated with a number of risk factors including prolonged ICU stay, different interventions and devices placement, prolonged mechanical ventilation and colonisation with micro-organisms coming from ICU environment. Because of the increased rate of emerging multi-drug-resistant pathogens, multidisciplinary infection control programmes have become a necessity in order to suppress antibiotic resistance and to improve the outcome of critically ill patients. Infection control in the ICU is based on general control measures, transmission-based (isolation) precautions, antibiotic utilisation policies, surveillance and decolonisation of the patients. Hand disinfection remains the cornerstone of the bundle of actions, which, apart from general infection control measures and transmission-based precautions, must have an antibiotic utilisation restriction policy as a priority. In parallel, specific infection's prevention strategies should be implemented, emphasising on ventilation-associated pneumonia and blood stream infections. Systematic surveillance reflects a tool with which the infection rates and the effectiveness of different measures could be evaluated. This information is objective of communication with administration authorities. Infection control committees are responsible for the education and adherence of nursing and medical staff to the methods of infection prevention. © Touch Briefings 2011.