Healthcare-associated infections in adult intensive care unit patients: Changes in epidemiology, diagnosis, prevention and contributions of new technologies.
Bloodstream infection
Catheter-related infections
Critically ill
Hospital-acquired infection
Infection prevention and control
Intensive care
Multidrug resistance
Pneumonia
Sepsis
Urinary tract infections
Journal
Intensive & critical care nursing
ISSN: 1532-4036
Titre abrégé: Intensive Crit Care Nurs
Pays: Netherlands
ID NLM: 9211274
Informations de publication
Date de publication:
Jun 2022
Jun 2022
Historique:
pubmed:
8
3
2022
medline:
11
5
2022
entrez:
7
3
2022
Statut:
ppublish
Résumé
Patients in intensive care units (ICUs) are at high risk for healthcare-acquired infections (HAI) due to the high prevalence of invasive procedures and devices, induced immunosuppression, comorbidity, frailty and increased age. Over the past decade we have seen a successful reduction in the incidence of HAI related to invasive procedures and devices. However, the rate of ICU-acquired infections remains high. Within this context, the ongoing emergence of new pathogens, further complicates treatment and threatens patient outcomes. Additionally, the SARS-CoV-2 (COVID-19) pandemic highlighted the challenge that an emerging pathogen provides in adapting prevention measures regarding both the risk of exposure to caregivers and the need to maintain quality of care. ICU nurses hold a special place in the prevention and management of HAI as they are involved in basic hygienic care, steering and implementing quality improvement initiatives, correct microbiological sampling, and aspects antibiotic stewardship. The emergence of more sensitive microbiological techniques and our increased knowledge about interactions between critically ill patients and their microbiota are leading us to rethink how we define HAIs and best strategies to diagnose, treat and prevent these infections in the ICU. This multidisciplinary expert review, focused on the ICU setting, will summarise the recent epidemiology of ICU-HAI, discuss the place of modern microbiological techniques in their diagnosis, review operational and epidemiological definitions and redefine the place of several controversial preventive measures including antimicrobial-impregnated medical devices, chlorhexidine-impregnated washcloths, catheter dressings and chlorhexidine-based mouthwashes. Finally, general guidance is suggested that may reduce HAI incidence and especially outbreaks in ICUs.
Identifiants
pubmed: 35249794
pii: S0964-3397(22)00030-1
doi: 10.1016/j.iccn.2022.103227
pmc: PMC8892223
pii:
doi:
Substances chimiques
Chlorhexidine
R4KO0DY52L
Types de publication
Journal Article
Langues
eng
Pagination
103227Commentaires et corrections
Type : CommentIn
Type : CommentIn
Informations de copyright
Copyright © 2022 Elsevier Ltd. All rights reserved.
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