Epidemiology of infections acquired in intensive care units

Infections acquired in the intensive care unit (ICU) are associated with significant morbidity and mortality. Using surveillance data collected in the United States and internationally, we describe contemporary rates, sites, and pathogens responsible for common ICU-acquired infections. Emerging pathogens are outlined, including a systematic review of published ICU infection outbreaks from 2005 to 2010. Compared with a similar review of outbreaks conducted in 2003, multiresistant gram-negative bacteria (eg, Acinetobacter and Pseudomonas species) were more commonly reported, whereas resistant Staphylococcus aureus was reported less frequently. Advances in ICU infection prevention, including central line bundles, chlorhexidine body wash, and hand hygiene interventions occurred during this period. We also describe how changes in the pattern of antimicrobial use can affect the prevalence of multiresistant pathogens.