Infection and Drug Resistance (May 2023)

Management of Bacterial and Fungal Infections in the ICU: Diagnosis, Treatment, and Prevention Recommendations

  • Rawson TM,
  • Antcliffe DB,
  • Wilson RC,
  • Abdolrasouli A,
  • Moore LSP

Journal volume & issue
Vol. Volume 16
pp. 2709 – 2726

Abstract

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Timothy M Rawson,1– 3 David B Antcliffe,2,4 Richard C Wilson,1– 3 Alireza Abdolrasouli,5 Luke SP Moore1,6,7 1Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance, Hammersmith Hospital, London, UK; 2Centre for Antimicrobial Optimisation, Imperial College London, Imperial College London, London, UK; 3David Price Evan’s Group in Infectious Diseases and Global Health, Department of Pharmacology and Therapeutics, University of Liverpool, Liverpool, UK; 4Division Anaesthesia, Pain Medicine and Intensive Care, Department of Surgery and Cancer, Imperial College London, London, UK; 5Department of Medical Microbiology, King’s College Hospital, London, UK; 6Chelsea & Westminster NHS Foundation Trust, London, UK; 7North West London Pathology, Imperial College Healthcare NHS Trust, London, UKCorrespondence: Timothy M Rawson, Health Protection Research Unit in Healthcare Associated Infections & Antimicrobial Resistance, Hammersmith Hospital, Du Cane Road, London, W12 0NN, United Kingdom, Email [email protected]: Bacterial and fungal infections are common issues for patients in the intensive care unit (ICU). Large, multinational point prevalence surveys have identified that up to 50% of ICU patients have a diagnosis of bacterial or fungal infection at any one time. Infection in the ICU is associated with its own challenges. Causative organisms often harbour intrinsic and acquired mechanisms of drug-resistance, making empiric and targeted antimicrobial selection challenging. Infection in the ICU is associated with worse clinical outcomes for patients. We review the epidemiology of bacterial and fungal infection in the ICU. We discuss risk factors for acquisition, approaches to diagnosis and management, and common strategies for the prevention of infection.Keywords: bacterial infection, fungal infection, critical care, diagnostics, therapeutics

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