The intensive care unit in antimicrobial resistance.
Many pressures play a role in escalating the emergence of antibiotic-resistant infections in intensive care units (ICUs), oncology and bone marrow transplant wards, and dialysis units. One is horizontal cross-transmission of antibiotic-resistant infections; another is the frequent use of broad-spectrum antibiotics. Among the serious infections acquired by patients in ICUs are bloodstream infections and nosocomial pneumonia. This article discusses potential multidisciplinary interventions to prevent bacterial resistance. Among these wide-ranging strategies are adequate decontamination between patient contacts, antibiotic guidelines to limit unnecessary use, and use of combination antimicrobial therapy.
Koleff
M H
MH
Department of Internal Medicine, Pulmonary and Critical Care Division, Washington University School of Medicine, 660 S Euclid Ave., St Louis, MO 63110, USA. kollefm@msnotes.wustl.edu
D003428:Cross Infection / Q000188:drug therapy / Q000382:microbiology*; D024901:Drug Resistance, Multiple, Bacterial / Q000187:drug effects*; D006801:Humans; D017053:Infection Control / Q000379:methods; D007362:Intensive Care Units / Q000706:statistics & numerical data*; D055624:Methicillin-Resistant Staphylococcus aureus / Q000187:drug effects; D053717:Pneumonia, Ventilator-Associated / Q000188:drug therapy / Q000382:microbiology*; D012307:Risk Factors; D018805:Sepsis / Q000188:drug therapy / Q000382:microbiology*