Infection Prevention in the Intensive Care Unit (ICU)

Zusammenfassung Intensivpatienten haben aufgrund ihrer Grunderkrankung, haufig invasiver Behandlungstechniken und nicht selten immunsupprimierender oder Mikrobiota-verandernder Medikation ein besonders hohes Risiko, eine nosokomiale Infektion zu erleiden. 2016 waren dies laut European Centre for Disease Prevention and Control 8,4% aller Patienten, die langer als 2 Tage intensivmedizinisch betreut wurden 1 . Der Beitrag gibt eine ubersicht uber wichtige Konzepte und Ma ss nahmen zur Infektionspravention auf der Intensivstation. Abstract Secondary to the underlying disease, the need for invasive devices and frequent drug-induced changes in immunocompetence and microbiota, critically ill patients have a high risk of suffering nosocomial infections. According to data from the European Centre for Disease Prevention and Control (ECDC) this affects 8,4% of patients treated in an ICU for more than 48 hours. Key points of infection prevention are maintenance of the patients microbiota and sometimes individually chosen interventions to its restoration or focused manipulation; development and implementation of care bundles for frequently used medical devices and invasive treatments (esp. intravenous catheters and invasive ventilation); adequate staffing not only for physicians, nurses and other medical staff but also for housekeeping staff, infection surveillance and motivational feedback, patient empowerment and visitor involvement. Functional building design and well organized logistics assist in achieving infection prevention goals by fostering adherence to basic hygiene procedure, esp. hand hygiene and risk-adjusted use of personal protective equipment. Daily interdisciplinary rounds following the principles of crew resource management strategies allow the structured check for unnecessary devices and inadequate use of antiinfective agents in particular and the discussion of all aspects of the patients situation in general.