Antimicrobial stewardship in the intensive care unit

Türe, Zeynep; Güner, Rahmet; Alp, Emine

doi:10.1016/j.jointm.2022.10.001

Cited by 14 publications

(7 citation statements)

References 89 publications

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“…ASPs are multifaceted strategies aimed at optimizing the use of antibiotics [ 66 ]. This can be achieved by ensuring the correct dosing, choosing the appropriate antibiotic, and regulating the duration and route of administration [ 67 ]. These elements of ASPs can collectively reduce the overall exposure to antibiotics and therefore minimize the emergence of the resistance and colonization of MDR bacteria [ 68 ].…”

Section: Antimicrobial Surveillance and Stewardshipmentioning

confidence: 99%

Preventing Multidrug-Resistant Bacterial Transmission in the Intensive Care Unit with a Comprehensive Approach: A Policymaking Manual

Schinas,

Polyzou,

Spernovasilis

et al. 2023

Antibiotics

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Patients referred to intensive care units (ICU) commonly contract infections caused by multidrug-resistant (MDR) bacteria, which are typically linked to complications and high mortality. There are numerous independent factors that are associated with the transmission of these pathogens in the ICU. Preventive multilevel measures that target these factors are of great importance in order to break the chain of transmission. In this review, we aim to provide essential guidance for the development of robust prevention strategies, ultimately ensuring the safety and well-being of patients and healthcare workers in the ICU. We discuss the role of ICU personnel in cross-contamination, existing preventative measures, novel technologies, and strategies employed, along with antimicrobial surveillance and stewardship (AMSS) programs, to construct effective and thoroughly described policy recommendations. By adopting a multifaceted approach that combines targeted interventions with broader preventive strategies, healthcare facilities can create a more coherent line of defense against the spread of MDR pathogens. These recommendations are evidence-based, practical, and aligned with the needs and realities of the ICU setting. In conclusion, this comprehensive review offers a blueprint for mitigating the risk of MDR bacterial transmission in the ICU, advocating for an evidence-based, multifaceted approach.

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Section: Antimicrobial Surveillance and Stewardshipmentioning

confidence: 99%

Preventing Multidrug-Resistant Bacterial Transmission in the Intensive Care Unit with a Comprehensive Approach: A Policymaking Manual

Schinas,

Polyzou,

Spernovasilis

et al. 2023

Antibiotics

View full text Add to dashboard Cite

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“…This condition contributes to reaching a specific setting-related ecosystem due to extensive sanitation protocols, prolonged antimicrobial treatments, and protracted recoveries. Each aspect may select species that can subvert the native microbial communities, developing hypervirulence, resistance patterns, and biofilm formation capability [ 1 , 2 ].…”

Section: Introductionmentioning

confidence: 99%

“…The intrinsic ICU-related ecosystem provides the ideal substrate to generate an unsettling scenario, comprising the persistence of the microorganisms, the difficult-to-treat appearance of the pathogens, and the intense patients’ vulnerability to infections [ 2 ]. ICU patients frequently have comorbidities, immunosuppression, and seniority and often experience invasive procedures and external device implantation.…”

Section: Introductionmentioning

confidence: 99%

“…Specifically, multidrug-resistant (MDR) pathogens hold high morbidity and mortality rates among ICUs [2]. On that premise, it is essential to correctly distinguish between Antibiotics 2024, 13, 238 2 of 15 colonization and infection conditions by applying standardized clinical and diagnostic protocols.…”

Section: Introductionmentioning

confidence: 99%

“…These samples are not always requested in intensive care settings, with only some documented data of their usefulness 2. Tracheal aspirate in the case of mechanical ventilation, along with samples from chronic ulcers and urine from catheters may be collected in the case of unconsciousness 3.…”

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confidence: 99%

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Bacterial Infections in Intensive Care Units: Epidemiological and Microbiological Aspects

Calvo,

Stefani,

Migliorisi

2024

Antibiotics

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Intensive care units constitute a critical setting for the management of infections. The patients’ fragilities and spread of multidrug-resistant microorganisms lead to relevant difficulties in the patients’ care. Recent epidemiological surveys documented the Gram-negative bacteria supremacy among intensive care unit (ICU) infection aetiologies, accounting for numerous multidrug-resistant isolates. Regarding this specific setting, clinical microbiology support holds a crucial role in the definition of diagnostic algorithms. Eventually, the complete patient evaluation requires integrating local epidemiological knowledge into the best practice and the standardization of antimicrobial stewardship programs. Clinical laboratories usually receive respiratory tract and blood samples from ICU patients, which express a significant predisposition to severe infections. Therefore, conventional or rapid diagnostic workflows should be modified depending on patients’ urgency and preliminary colonization data. Additionally, it is essential to complete each microbiological report with rapid phenotypic minimum inhibitory concentration (MIC) values and information about resistance markers. Microbiologists also help in the eventual integration of ultimate genome analysis techniques into complicated diagnostic workflows. Herein, we want to emphasize the role of the microbiologist in the decisional process of critical patient management.

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