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Abstract
Traditional infection control measures in intensive care units (ICUs) have been directed
at limiting person to person spread of infection and improving care of invasive devices.
These measures often fail because they have little effect on patients' endogenous
flora, which is an important source of infection in ICUs. Improvements in the design
and aseptic care of invasive devices have helped to decrease the risk of progression
from colonization to infection in individual patients. Interest is growing also in
use of selective decontamination to decrease ICU infection rates. Despite these advances,
basic hygiene and appropriate, prospectively monitored use of antibiotics remain essential
components of ICU care.
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References
- The intensive care unit.in: Bennett JV Brachman PS Hospital infections. Little, Brown, and Company, Boston1986: 285-298
- Strategies for prevention and control of multiple drug-resistant nosocomial infection.Am J Med. 1981; 70: 449-454
- Nosocomial infection rates in adult and pediatric intensive care units in the United States.Am J Med. 1991; 91: 101-165
- Nosocomial pneumonia.Am J Med. 1991; 91: 44-53
- Risk factors for nosocomial infection in intensive care.in: ‘Devices vs Nature’ and goals for the next decade. version 5 edition. Arch Intern Med. 149. 1989: 30-35
- Nosocomial bloodstream infection.([Abstract 3])in: Third Decennial International Conference on Nosocomial Infections, AtlantaJuly 31–August 3, 1990
- Extended use of disposable pressure transducers—a bacteriologic evaluation.JAMA. 1986; 255: 916-920
- Catheter-Associated urinary tract infections: Epidemiology, Pathogenesis and Prevention.Am J Med. 1991; 91: 65-71
- Epidemiology of endemic Pseudomonas aeruginosa: why infection control efforts have failed.J Infect Dis. 1984; 150: 808-816
- The epidemiology of Pseudomonas aeruginosa in oncology patients in a general hospital.J Infect Dis. 1989; 160: 1030-1036
- Occult aminoglycoside resistance in Pseudomonas aeruginosa: epidemiology and implications for therapy and control.J Infect Dis. 1985; 152: 769-775
- Pseudomonas in the sinks in an intensive care unit: relation to patients.J Clin Pathol. 1984; 37: 424-427
- Patients' endogenous flora as the source of “nosocomial” Enterobacter in cardiac surgery.J Infect Dis. 1987; 156: 363-368
- Infections with gram-negative bacilli in a cardiac surgery intensive care unit: the relative role of enterobacter.J Hosp Infect. 1988; 11: 367-373
- Endemic emergence of cephalosporin-resistant enterobacter: relation to prior therapy.Infect Control. 1986; 7: 120-123
- Inducible beta-lactamases: clinical and epidemiologic implications for use of newer cephalosporins.Rev Infect Dis. 1988; 10: 830-838
- Gentamicin-resistant staphylococci as hospital flora: epidemiology and resistance plasmids.J Infect Dis. 1982; 145: 374-382
- Low-level colonization of hospitalized patients with methicillin-resistant coagulase-negative staphylococci and emergence of the organisms during surgical antmicrobial prophylaxis.Antimicrob Agents Chemother. 1988; 32: 202-208
- Identity and inter-specific transfer of gentamicin-resistance plasmids in Staphylococcus aureus and S. epidermidis.J Infect Dis. 1980; 141: 738-747
- The life and times of the enterococcus.Clin Microbiol Rev. 1990; 3: 46-65
- Nosocomial fungal infections in U.S. hospitals, 1980–1990.([Abstract 1129])in: Interscience Conference on Antimicrobial Agents and Chemotherapy, AtlantaOctober 21–24, 1990
- Minimizing the potential for nosocomial pneumonia: architectural, engineering, and environmental considerations for the intensive care unit.Eur J Clin Microbiol Infect Dis. 1989; 8: 69-74
- The effect of private isolation rooms on patient care practices, colonization and infection in an intensive care unit.Am J Med. 1981; 70: 641-645
- Endemic aminoglycoside resistance in gram-negative bacilli: epidemiology and mechanisms.J Infect Dis. 1980; 141: 338-345
- Reduction of nosocomial infection during pediatric intensive care by protective isolation.N Engl J Med. 1989; 320: 1714-1721
- Nosocomial pneumonia in intubated patients given sucralfate as compared with antacids or histamine type 2 blockers.in: The role of gastric colonization. version 5 edition. N Engl J Med. 317. 1987: 1376-1382
- Pilot trial of selective decontamination for prevention of bacterial infection in an intensive care unit.J Infect Dis. 1990; 162: 1393-1397
- Infection control and pneumonia prophylaxis strategies in the intensive care unit.Semin Respir Infect. 1990; 5: 191-203
- Selective intestinal decontamination—an infection control measure whose time has come?.Ann Intern Med. 1989; 110: 853-855
- Nosocomial gram-negative pneumonia in critically ill patients.in: A 3-year experience with a novel therapeutic regimen. version 5 edition. Intensive Care Med. 12. 1986: 419-423
- Prevention of colonization and respiratory infections in long-term ventilated patients by local antimicrobial prophylaxis.Intensive Care Med. 1987; 13: 106-113
- Triple regimen of selective decontamination of the digestive tract, systemic cefotaxime, and microbiological surveillance for prevention of acquired infection in intensive care.Lancet. 1988; 1: 785-790
- Nosocomial infection among patients in different types of intensive care units at a city hospital.Crit Care Med. 1986; 14: 508-510
- Nosocomial infection and fatality in medical and surgical intensive care unit patients.Arch Intern Med. 1988; 148: 1161-1168
- The effect of oral nonabsorbable antibiotics on the emergence of resistant bacteria in patients in an intensive care unit.J Antimicrob Chemother. 1987; 19: 513-520
- Intestinal decontamination for control of nosocomial multiresistant gram-negative bacilli.in: Study of an outbreak in an intensive care unit. version 5 edition. Ann Intern Med. 110. 1989: 873-881
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© 1991 Published by Elsevier Inc.
