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Increasing prevalence of antimicrobial resistance in intensive care units
1Hospital Infections Program, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA.
Abstract:
The unique nature of the intensive care unit (ICU) environment makes this part of the hospital a focus for the emergence and spread of many antimicrobial-resistant pathogens. There are ample opportunities for the cross-transmission of resistant bacteria from patient to patient, and patients are commonly exposed to broad-spectrum antimicrobial agents. Rates of resistance have increased for most pathogens associated with hospital-acquired infections among ICU patients, and rates are almost universally higher among ICU patients than non-ICU patients. Likewise, ICU patients hospitalized longer (i.e., >7 days) are two- to three-fold more likely to be infected with a pathogen possessing an antimicrobial-resistant phenotype of concern. However, there are many opportunities to prevent the emergence and spread of these resistant pathogens through improved use of established infection control measures (patient isolation, handwashing, glove use, and appropriate gown use) and implementation of a systematic review of antimicrobial use. (Crit Care Med 2001; 29[Suppl.]: N64-N68)
Insights
Intensive care units (ICUs) are hotspots for antimicrobial-resistant pathogens due to patient proximity and broad-spectrum antibiotic use. Improved infection control and antimicrobial stewardship can prevent the spread of these dangerous resistant bacteria.
Area of Science:
- Infectious Diseases
- Critical Care Medicine
- Microbiology
Background:
- Intensive care units (ICUs) present unique challenges for infection control.
- The ICU environment facilitates the emergence and transmission of antimicrobial-resistant pathogens.
- Patients in ICUs are frequently exposed to broad-spectrum antimicrobial agents.
Purpose of the Study:
- To highlight the increased risk of antimicrobial resistance in ICUs.
- To discuss factors contributing to the spread of resistant pathogens in ICUs.
- To emphasize the importance of infection control and antimicrobial stewardship in preventing resistance.
Main Methods:
- Review of existing literature on antimicrobial resistance in ICUs.
- Analysis of pathogen resistance rates in ICU versus non-ICU patients.
- Identification of risk factors for resistant infections in prolonged ICU stays.
Main Results:
- Antimicrobial resistance rates are higher for most pathogens in ICUs compared to non-ICUs.
- Patients with longer ICU stays (>7 days) have a 2-3 times higher risk of infection with resistant pathogens.
- Cross-transmission of resistant bacteria is common in the ICU setting.
Conclusions:
- ICUs are critical areas for monitoring and controlling antimicrobial resistance.
- Enhanced infection control measures, including hand hygiene and isolation precautions, are essential.
- Systematic review of antimicrobial use (antimicrobial stewardship) is crucial for preventing resistance.