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.