[Multidrug resistant bacteria in the intensive care unit : Reasonable measures for prevention]

Multidrug resistant (MDR) bacteria present an increasing threat for intensive care patients. Whereas colonization of intensive care patients with methicillin-resistant staphylococcus aureus (MRSA) in German ICUs has remained at a constant level in recent years and therapeutic options have improved, colonization and infections with MDR gram-negative bacteria and vancomycin-resistant enterococci are increasing year by year. Only a few or even no therapeutic options remain for the treatment of these bacteria. If recommendations and guidelines for the prevention of transmission of MDR bacteria do exist they often are of moderate evidence due to lack of randomized controlled trials. The single most important measure to avoid transmission and infection with sensible and MDR bacteria is still hand disinfection. Screening and barrier precautions must be adapted and implemented to pathogen and local conditions. In addition to those specific measures universal decolonization with antiseptics have been demonstrated to be effective at least in intensive care patients.