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Microbiological surveillance in the critically ill 

Microbiological surveillance in the critically ill
Chapter:
Microbiological surveillance in the critically ill
Author(s):

A. P. R. Wilson

DOI:
10.1093/med/9780199600830.003.0281
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date: 24 February 2020

Patients in the ICU are at high risk of acquiring multiresistant pathogens. Surveillance quickly identifies outbreaks and promotes antimicrobial stewardship. Catheter-related bacteraemia is often used as a performance measure and intervention using a package of preventative measures can be very successful. Ventilator-associated pneumonia in contrast can be difficult to define accurately. Water sources should be monitored. Pseudomonas aeruginosa may become established in taps and cause invasive infections especially in neonates. Screening of nasal swabs for MRSA followed by topical suppression has been effective in reducing spread during ICU admission. With rising prevalence of multiresistant Gram-negative species, screening of faeces or rectal swabs may become necessary. Acinetobacter is very disruptive if it causes an outbreak and it can be difficult to control. Screening is one method of limiting its’ spread. National surveillance networks are increasing and may be mandatory as they appear to be successful in controlling nosocomial infection.

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