Evidence-based infection control in the ICU (except catheters).

PURPOSE OF REVIEW

To evaluate the recent literature on new randomized controlled trials and metaanalyses investigating infection control measures in the ICU. The focus is on ventilator-associated pneumonia, urinary tract infections and surgical site infections.

RECENT FINDINGS

At least 10 randomized controlled studies and 11 metaanalyses were published last year investigating various infection control measures for preventing ventilator-associated pneumonia, urinary tract infections and surgical site infections in ICU patients. They endorsed existing recommendations and led to some changes in the present guidelines. One of the most interesting findings was evidence for the routine use of oral chlorhexidine gluconate rinse to decrease ventilator-associated pneumonia rates. Furthermore, several cohort studies with a before-after design were published and demonstrated a substantial reduction in infection rates by introducing multimodal infection control programs.

SUMMARY

There is currently enormous interest in the field of infection control in ICU patients. Experts in this field are aiming to summarize existing knowledge on decreasing nosocomial infection rates and to update guidelines. Translating infection prevention evidence into practice, however, is also a very import element of ICU infection control and should be the main focus of further studies.