The epidemiology of infections in intensive care units.

This report identifies some of the risk factors underlying the acquisition of hospital infections in patients admitted to Intensive Care Units (ICUs). Infection rates vary in different institutes and in different types of ICUs. Patients are particularly prone to septicaemia and respiratory infections and the underlying risk factors are frequently related to poor invasive techniques or contaminated equipment used in supportive therapy. In trauma patients, wound sepsis is common and polymicrobial sepsis is a major problem. Patients in ICUs are temporarily immunocompromised and are at risk from acquiring multiply antibiotic resistant gram negative bacilli. The majority of these are of an endogenous nature and necessitate the empirical use of antibiotics. The misuse of antibiotics however often leads to the selection of difficult to treat gram negative bacilli. Antibiotic usage in ICUs should be strictly controlled and used appropriately, preferably after appropriate microbiological specimens have been collected.