Infection Control in the Intensive Care Unit

ABOUT THIS BOOK

• Contains a new chapter on microcirculation
• The already existing chapters have been rearranged and updated on the basis of the most recent meta-analyses
• Particular attention is given to SDD
• Text is enriched by many tables and figures

Intensive care is a rapidly changing area of medicine; this third edition of "Infection Control in the Intensive Care Unit" has the same format as the previous one but covers a wider scope of infection prevention, from lower airways to bloodstream.

This edition condenses and updates the information of the previous edition, with the addition of new tables and figures, and contains two completely new chapters on microcirculation and mechanisms of action behind the efficacy of Selective Decontamination of the Tract.

SDD is an antimicrobial prophylaxis to prevent severe infections that has been proved to reduce inflammation; there is now evidence that SDD using parenteral and enteral antimicrobials reduces rather than increases antimicrobial resistance. Latest results are here taken into account; 10 new randomised controlled trials and 2 recent meta-analyses with endpoints of multiple organ failure and resistance. The outbreak chapter is substantially reduced and builds on the previous issue; it now includes polyclonality within outbreaks.

This up-to-date and comprehensive study will be welcomed by intensive care specialists, clinical microbiologists, infection disease specialists and clinical pharmacists who wish to learn about the most recent discoveries and advances in infection control. It will also be of interest to advanced undergraduates wanting to learn more about the subject.

Content Level » Professional/practitioner
Keywords » Infection control - intensive care - mortality - resistance
Related subjects » Critical Care & Emergency Medicine - Internal Medicine - Medical Microbiology - Pharmaceutical Science

TABLE OF CONTENTS

• Foreword
• Preface

Section 1 Essentials in Clinical Microbiology:

• Glossary of terms and definitions
• Carriage, colonization, infection
• Classification of micro-organisms
• Classification of ICU infection
• Gut Microbiology: Surveillance Samples for the Detection of the Abnormal Carrier State in Overgrowth

Section 2 Antimicrobials:

• Systemic antibiotics
• Systemic Antifungals
• Enteral antimicrobials

Section 3 Infection Control:

• Evidence-based infection control in the ICU
• Devices policies
• Antibiotic Policies in the Intensive Care Unit
• Outbreaks of infection in the ICU
• Selective decontamination of the digestive tract

Section 4 Infections on ICU:

• Lower airway infection
• Bloodstream infection in the ICU
• Infections of peritoneum, mediastinum, pleura, wounds and urinary tract
• Infection on the NICU and PICU
• Early adequate antibiotic therapy
• ICU for transplantation
• Clinical virology in NICU, PICU and adult ICU
• AIDS patients on ICU
• Therapy of infection in the IC

Section 5 Special topics:

• The gut in the critically ill: central organ in abnormal microbiological carriage, infections, systemic inflammation, microcirculatory failure and MODS
• Non-antibiotic measures to control ventilator-associated pneumonia
• Impact of nutritional route on infections: parenteral versus enteral
• Gut mucosal protection in the critically ill patient towards an integrated clinical strategy
• Selective Decontamination of the Digestive Tract: The Role of the Pharmacist
• Antimicrobial resistance

AUTHORS & EDITORS

Hendrik van Saene studied medicine at the University of Leuven (Belgium), and was awarded an M.D. in 1973. He trained and qualified as a medical microbiologist at the University of Groningen (The Netherlands) in 1977.

His most recent clinical research involves the administration of enteral vancomycin to control MRSA pneumonia and outbreaks (European Respiratory Journal 2004; 23: 921-926; Journal of Hospital Infection 2004; 56: 175-183; Annals of Surgery 2007; 245: 397-407). Dr van Saene has been awarded European research prizes, the Fellowship of the Royal College of Pathologists, Merit Awards and Readership for his infection prevention work using selective decontamination. The validity of this strategy has been confirmed in individual trials and recent meta-analyses showing a significant reduction in overall mortality by 8% and a relative reduction by 29% (American Journal of Respiratory and Critical Care Medicine 2002; 166: 1029-1037; Lancet 2003; 362: 1011-1016; The Cochrane Library, Issue 1, Chichester, UK: John Wiley & Sons Ltd. 2004; Journal of Critical Care 2009; in press). During the last four years, Dr Silvestri and he meta-analysed all randomised controlled trials on SDD, in five different meta-analyses. He is the author and/or co-author of 300 publications, of which approximately 200 are available on the internet.

Dr. Miguel de la Cal is responsible for the ICU Unit of the Santa Coruna Hospital in Madrid and Dr. Luciani Silvestri is in charge of the Unit of Anesthesia and Resuscitation of the Gorizia Hospital. They have cooperated also on the previous editions of the volume.