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Infection control measures to decrease the burden of antimicrobial resistance in the critical care setting

Caroline Landelle1, Kalisvar Marimuthu, Stephan Harbarth

  • 1aInfection Control Program, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland bInstitute of Infectious Diseases and Epidemiology, Tan Tock Seng Hospital, Singapore.

Current Opinion in Critical Care
|July 18, 2014
PubMed
Abstract

Insights

Infection control measures like hand hygiene and decolonization can reduce multidrug-resistant organisms (MDROs) in intensive care units (ICUs). Tailoring strategies to local ICU epidemiology is crucial for effective resistance burden reduction.

Area of Science:

  • Infectious Diseases
  • Critical Care Medicine
  • Public Health

Background:

  • Increasing prevalence of multidrug-resistant organisms (MDROs) in intensive care units (ICUs) globally.
  • Antimicrobial resistance poses a significant threat to patient outcomes in critical care settings.

Purpose of the Study:

  • To review infection control measures, excluding antibiotic stewardship, for reducing MDRO resistance in ICUs.
  • To assess the effectiveness of various interventions in preventing MDRO transmission.

Main Methods:

  • Systematic review of recent high-quality clinical studies.
  • Analysis of data on hand hygiene, decolonization, and selective decontamination.

Main Results:

  • Enhanced understanding of hand hygiene's role in reducing methicillin-resistant Staphylococcus aureus (MRSA).
  • Universal decolonization with chlorhexidine shows promise in reducing MDROs, necessitating vigilance for resistance.
  • Selective decontamination reduced Gram-negative bacilli resistance, but requires further trials for long-term risk/benefit assessment.

Conclusions:

  • Significant progress in identifying effective interventions, particularly decolonization, for preventing MDRO transmission in ICUs.
  • The precise and relative importance of different infection control measures remains challenging to determine.
  • Intervention strategies must be individualized based on the specific ICU's local epidemiology.

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