{"title":"重症监护室中的医院内感染","authors":"Frances Lanaghan, Peter Stenhouse","doi":"10.1016/j.mpaic.2024.07.003","DOIUrl":null,"url":null,"abstract":"<div><div>Nosocomial infections are associated with a significant morbidity, mortality, resource and financial burden in ICU. Critical care patients are at an increased risk of developing infections compared to patients elsewhere in hospital due to underlying comorbidities of the patient, the acute disease process and treatments required. There is a strong association with indwelling devices in the ICU population. As such, daily review of ongoing requirement for the invasive device and the application of care bundles, as well as the introduction of local policies targeting hand hygiene and infection control protocols to manage infections have been promoted. Ventilator-acquired pneumonia and catheter-related infections are most common. Management of these frequently involves empirical antimicrobials, although targeted therapy based on culture sensitivities and input from the local microbiology team and infection control team are suggested. There is an increasing burden of antimicrobial resistance in part due to the clinical condition of ICU patients and the frequent use of empirical broad-spectrum antibiotics.</div></div>","PeriodicalId":45856,"journal":{"name":"Anaesthesia and Intensive Care Medicine","volume":null,"pages":null},"PeriodicalIF":0.2000,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Nosocomial infections in the intensive care unit\",\"authors\":\"Frances Lanaghan, Peter Stenhouse\",\"doi\":\"10.1016/j.mpaic.2024.07.003\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><div>Nosocomial infections are associated with a significant morbidity, mortality, resource and financial burden in ICU. Critical care patients are at an increased risk of developing infections compared to patients elsewhere in hospital due to underlying comorbidities of the patient, the acute disease process and treatments required. There is a strong association with indwelling devices in the ICU population. As such, daily review of ongoing requirement for the invasive device and the application of care bundles, as well as the introduction of local policies targeting hand hygiene and infection control protocols to manage infections have been promoted. Ventilator-acquired pneumonia and catheter-related infections are most common. Management of these frequently involves empirical antimicrobials, although targeted therapy based on culture sensitivities and input from the local microbiology team and infection control team are suggested. There is an increasing burden of antimicrobial resistance in part due to the clinical condition of ICU patients and the frequent use of empirical broad-spectrum antibiotics.</div></div>\",\"PeriodicalId\":45856,\"journal\":{\"name\":\"Anaesthesia and Intensive Care Medicine\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.2000,\"publicationDate\":\"2024-10-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Anaesthesia and Intensive Care Medicine\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S1472029924001449\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"ANESTHESIOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Anaesthesia and Intensive Care Medicine","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1472029924001449","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"ANESTHESIOLOGY","Score":null,"Total":0}
Nosocomial infections are associated with a significant morbidity, mortality, resource and financial burden in ICU. Critical care patients are at an increased risk of developing infections compared to patients elsewhere in hospital due to underlying comorbidities of the patient, the acute disease process and treatments required. There is a strong association with indwelling devices in the ICU population. As such, daily review of ongoing requirement for the invasive device and the application of care bundles, as well as the introduction of local policies targeting hand hygiene and infection control protocols to manage infections have been promoted. Ventilator-acquired pneumonia and catheter-related infections are most common. Management of these frequently involves empirical antimicrobials, although targeted therapy based on culture sensitivities and input from the local microbiology team and infection control team are suggested. There is an increasing burden of antimicrobial resistance in part due to the clinical condition of ICU patients and the frequent use of empirical broad-spectrum antibiotics.
期刊介绍:
Anaesthesia and Intensive Care Medicine, an invaluable source of up-to-date information, with the curriculum of both the Primary and Final FRCA examinations covered over a three-year cycle. Published monthly this ever-updating text book will be an invaluable source for both trainee and experienced anaesthetists. The enthusiastic editorial board, under the guidance of two eminent and experienced series editors, ensures Anaesthesia and Intensive Care Medicine covers all the key topics in a comprehensive and authoritative manner. Articles now include learning objectives and eash issue features MCQs, facilitating self-directed learning and enabling readers at all levels to test their knowledge. Each issue is divided between basic scientific and clinical sections. The basic science articles include anatomy, physiology, pharmacology, physics and clinical measurement, while the clinical sections cover anaesthetic agents and techniques, assessment and perioperative management. Further sections cover audit, trials, statistics, ethical and legal medicine, and the management of acute and chronic pain.