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Editorials |

Time To Get Serious About Infection Prevention in the ICU

Marin H. Kollef, MD, FCCP
Author and Funding Information

Affiliations: St. Louis, MO
 ,  Dr. Kollef is Professor of Medicine, Washington University School of Medicine; Director, Medical Intensive Care Unit; and Director, Respiratory Care Services, Barnes-Jewish Hospital.

Correspondence to: Marin H. Kollef, MD, FCCP, Campus Box 8052, Washington University School of Medicine, 660 South Euclid Ave, St. Louis, MO 63110; e-mail: mkollef@im.wustl.edu



Chest. 2006;130(5):1293-1296. doi:10.1378/chest.130.5.1293
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ICUs are an important area for the emergence and spread of nosocomial infections due to the frequent use of broad-spectrum antibiotics; the crowding of patients with high levels of disease acuity within relatively small specialized areas; reductions in nursing staff and other support staff due to economic pressures that increase the likelihood of person-to-person transmission of microorganisms; and the presence of more chronically and acutely ill patients who require prolonged hospitalizations and often harbor antibiotic-resistant bacteria.13 Increasingly nosocomial infections, especially those acquired in the ICU setting, are caused by antimicrobial-resistant pathogens. Therefore, clinicians need to be aware of strategies that are not only aimed at prevention of nosocomial infections but the prevention of antimicrobial resistance as well. Many of the available prevention strategies are described in the Centers for Disease Control and Prevention 12-step program for the prevention of antimicrobial resistance (http://www.cdc.gov/drugresistance/healthcare/). One of the key elements in this strategy is to consult experts in the field of nosocomial infections and antimicrobial resistance (eg, infectious disease experts, infection control practitioners, microbiologists) when designing interventions aimed at minimizing the emergence and spread of antibiotic resistant pathogens.

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