Bearman Gonzalo M L, Munro Cindy, Sessler Curtis N, Wenzel Richard P
Division of Quality HealthCare, Virginia Commonwealth University Medical Center, Richmond, Virginia 23298-0019, USA.
Semin Respir Crit Care Med. 2006 Jun;27(3):310-24. doi: 10.1055/s-2006-945534.
Nosocomial infections continue to be significant causes of morbidity, mortality, and added costs in the health care setting. Half of all life-threatening nosocomial bloodstream infections and pneumonias occur in intensive care units (ICUs), despite ICUs representing only 15 to 20% of all hospital beds. Thus an efficient focus for prevention and control of life-threatening health care-associated infections should be in ICUs. Further, growing antibiotic resistance complicates the therapy of serious infections. Meticulous infection control practice with continued attention to hand hygiene is of paramount importance. Strict adherence to evidence-based catheter insertion and maintenance policies reduces nosocomial bloodstream infections. Evidence-based prevention strategies for ventilator-associated pneumonia, including management of respiratory equipment according to published guidelines and maintaining backrest elevation at 30 to 45 degrees, are effective. For greatest risk reduction, multifaceted programs ensuring maximal adherence with evidence-based infection control guidelines are needed.
医院感染仍然是医疗环境中发病、死亡和额外费用的重要原因。尽管重症监护病房（ICU）仅占医院病床总数的15%至20%，但所有危及生命的医院血流感染和肺炎中有一半发生在ICU。因此，预防和控制危及生命的医疗相关感染的有效重点应放在ICU。此外，日益增加的抗生素耐药性使严重感染的治疗变得复杂。认真落实感染控制措施并持续关注手部卫生至关重要。严格遵守基于证据的导管插入和维护政策可减少医院血流感染。基于证据的呼吸机相关性肺炎预防策略，包括根据已发布的指南管理呼吸设备并将靠背抬高至30至45度，是有效的。为了最大程度降低风险，需要多方面的计划以确保最大程度地遵守基于证据的感染控制指南。
