Infection Control and Preventive Strategies in ICU

Abstract

The infections acquired during stay in ICU represent a noticeable problem during treatment of critically ill patient. The acquired infections prolong the duration of stay in ICU, financial costs of treatment, morbidity and mortality critically ill patients. The ICU represent a unique place gathering the patients with multiple morbidity, reduced immunity, and need for many interventions that penetrate the body defenses, leaving the patient exposed to invasion of microorganisms. Moreover, the condensed use of antibiotics for infection favours the emergence of antibiotic-resistant strains of many bacterial species. The definitions and criteria adopted by surveillance differ from those used in clinical practice. The 48 hours time cut-off usually overestimates the incidence of ICU acquired infections. In near future, it’s expected that the bacterial content and carriage state of the patient on admission will prevail as a criterion for distinguishing the healthcare- associated infections from the community acquired one. Many strategies have been put to avoid or reduce the risk of the ICU-acquired infections. Infection control strategies in ICU are divided into universal precautions, taken with every patient, irrespective to his/her status, and transmission-based precautions that depend on the mode of transmission of the infection. Another group of preventive procedures are directed to the device used and aim to prevent the infection caused by the device. Selective Decontamination of Digestive tract represents an outstanding procedure that resisted the changes over more than 30 years, yet it’s still not widely practiced.