{"id":8128,"date":"2023-04-19T00:50:52","date_gmt":"2023-04-18T22:50:52","guid":{"rendered":"https:\/\/www.amil-care.com\/2023\/04\/19\/prevenzione-infezioni-terapia-intensiva\/"},"modified":"2023-06-13T15:44:54","modified_gmt":"2023-06-13T13:44:54","slug":"infection-prevention-intensive-care-unit","status":"publish","type":"post","link":"https:\/\/www.amil-care.com\/en\/2023\/04\/19\/infection-prevention-intensive-care-unit\/","title":{"rendered":"Infections in the intensive care unit (ICU)"},"content":{"rendered":"

The intensive care unit (ICU<\/span><\/b>) of hospitals has always been the place where the most vulnerable patients are kept so that they can be monitored and treated with particular attention, often also thanks to a close relationship between nurse and patient. Even with the great advances in medical technology, these patients continue to be at greater risk of infections: yet, with <\/span>proper sanitization<\/span><\/b>, many of these could be avoided.<\/span>\u00a0<\/span><\/p>\n

For this reason, we at AMIL Care have decided to dedicate a specific article to <\/span>infections in intensive care<\/span><\/b> units (ICU)<\/span><\/b>, <\/span>referring in particular to professional figures such as the Purchasing Manager in hospital facilities, the Medical Equipment Management Managers, Clinical Engineers (Aiic), Safety and Hygiene Managers (HSE), and also Clinical Risk Management Managers.<\/span>\u00a0<\/span><\/p>\n

What are nosocomial infections?<\/h2>\n

By <\/span>\u201cnosocomial infection\u201d<\/span> we generally mean those infections that are not present or incubating when the patient is admitted to a hospital or other healthcare facility. The time frame for the diagnosis of a <\/span>nosocomial infection <\/span><\/b>will therefore clearly depend on the incubation period of the specific infection; 48 to 72 hours after admission are generally considered indicative of a nosocomial infection. Although generally associated with hospitalization, nosocomial infections can arise after admission to any healthcare facility, and the term healthcare-associated infection is increasingly used. Such infections are common and associated with great morbidity and mortality.<\/span>\u00a0<\/span><\/p>\n

When these infections occur in <\/span>intensive care<\/span><\/b>, we speak of ICU or infections acquired in intensive care.<\/span>\u00a0<\/span><\/p>\n

How are bacteria transmitted in the hospital and in the ICU?<\/h2>\n

In intensive care units, <\/span>patients often come from other wards <\/span><\/b>and <\/span>have been treated for something before their admission<\/span><\/b>. This potentially predisposes them to have a resistant microorganism as the cause of the infection. These patients can then become a danger to the entire unit and put other patients and healthcare personnel at risk.<\/span>\u00a0<\/span><\/p>\n

Transmission by contact can occur in several ways, through direct contact of secretions with the patient, contact with a contaminated surface\/equipment, and the hands of health care workers. Any of these routes of transmission can pose a significant problem for any facility.<\/span>\u00a0<\/span><\/p>\n

The intensive care unit occupied by problematic and risky cases is paradoxically the one in which compliance with hand hygiene and other preventive infection control practices tends to be reduced. In the ICU, there are so many clinical staff involved in patient care, and so much to do, that the risk of transfer of microorganisms increases.<\/span>\u00a0<\/span><\/p>\n

The question does not end here. Unfortunately, patients can also contract new infections while in intensive care, as the immune system does not work properly. Additionally, invasive devices, such as needles and tubes, are inserted into the body as part of regular intensive care treatments. These devices bypass the body’s normal <\/span>defenses,<\/span> such as the outer layers of the skin.<\/span>\u00a0<\/span><\/p>\n

In addition, some invasive treatments can increase the risk of infection, such as intubation, intravenous drug administration, or insertion of catheters to drain the bladder.<\/span>\u00a0<\/span><\/p>\n

What are the most common hospital infections?<\/h2>\n

Patients admitted to the ICU are at increased risk of nosocomial infections<\/span><\/b>, which increase patient morbidity, increase length of stay and hospital costs, and may increase mortality rates.<\/span>\u00a0<\/span><\/p>\n

Infections in which Gram-positive pathogens are responsible, for example, <\/span>Staphylococcus aureus<\/span><\/i>, <\/span>Staphylococcus epidermidis, <\/span><\/i>and enterococci are particularly common in intensive care units <\/span>(this is evidenced by prestigious studies, such as a study published in PubMed), but not only.<\/span>\u00a0<\/span><\/p>\n

The <\/span>most common infections <\/span><\/b>acquired in <\/span>intensive care <\/span><\/b>are pneumonia, other lower respiratory tract infections, urinary tract infections, and bloodstream infections. The bacterial isolates were equally divided between Gram-negative and Gram-positive species. The bacteria commonly reported in cases of infection in intensive care are Enterobacteriaceae, Staphylococcus aureus, and Pseudomonas aeruginosa.<\/span>\u00a0<\/span>\u00a0<\/span><\/p>\n

Prevent infections in intensive care<\/h2>\n

Infection prevention in the ICU<\/span><\/b> relies on the application of effective strategies over extended periods only if they can be integrated into the behavior of all staff involved in patient care.<\/span>\u00a0<\/span><\/p>\n

Consequently, infection control measures must be prioritized and must be fully integrated into the ongoing process of improving quality of care.<\/span>\u00a0<\/span><\/p>\n

There are four areas of prevention in which healthcare personnel are required to pay attention:<\/span>\u00a0<\/span><\/p>\n