Microbes and infection
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The prevention of nosocomial infections is an important aspect of patient care, particularly in high-risk areas such as intensive care units (ICUs). Local hospital leadership needs to develop easily defined infection-control policies that are evidence-based. These infection-control policies also require the presence of a dedicated group of infection-control practitioners to provide education, collect surveillance data, and oversee the implementation of the local infection-control plan.
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Microbes and infection · Feb 2005
Respiratory nosocomial infections in the medical intensive care unit.
Intensive care unit (ICU)-acquired lower respiratory tract infections include acute tracheobronchitis and hospital-acquired and ventilator-associated pneumonia (VAP). Nosocomial pneumonia is the second most common hospital-acquired infection and the leading cause of death in hospital-acquired infections. The mortality rate in VAP ranges from 24% to 76% in several studies. ⋯ Once the physician decides to treat a suspected episode of ICU-acquired pneumonia, some issues should be kept on mind: first, the adequacy of the initial empiric antibiotic therapy; second, the modification of initial inadequate therapy according to microbiological results; third, the benefit of combination therapy; and finally, the duration of the antimicrobial treatment. Additionally, a protocolized work-up to identify the causes of non-response to treatment is mandatory. All these issues are discussed in depth in this article.