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Lower Airway Infection

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Infection Control in the Intensive Care Unit

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Abstract

Ventilator-associated pneumonia (VAP) is the most important infectious complication in intensive care units (ICU), and despite advances in knowledge regarding the physiopathology, diagnosis, and prevention of this disease, the mortality rate continues to be unacceptably high, mainly when the cause is Pseudomonas aeruginosa and methicillin-resistant Staphylococcus aureus (MRSA). VAP also increases days of mechanical ventilation and length of ICU and hospital stay, which is dependent on host factors, causative organisms, timing and adequacy of treatment, and presence of intrinsic or inducible antibiotic resistance. Despite available diagnostic procedures, diagnosing VAP continues to be a clinical one. The presence of X-ray infiltrates and purulent endotracheal secretions are the essential conditions for the diagnosis. Our ability to reduce the occurrence of VAP in the hospital setting has been significantly improved, and it needs a combination of several actions that include hygienic measures aimed at reducing cross-infection between patients, preventing aspiration of contaminated oropharyngeal secretions, avoiding prolonged mechanical ventilation, and modulating oropharyngeal flora.

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Author information

Authors and Affiliations

  1. Servei de Cures Intensives, Consorci Sanitari del Maresmes, UAB, CibeRes (CB06/06/0028), Mataró, Spain

    J. Almirall

  2. 1st Department of Respiratory Medicine, <<SOTIRIA>> , Regional Chest Disease Hospital of Athens, 152 Mesogeion Street, 11527, Athens, Greece

    A. Liapikou

  3. Servei de Pneumologia i Allèrgia Respiratòria, Hospital Clínic, IDIBAPS, CibeRes (CB06/06/0028), Villarroel 170, 08036, Barcelona, Spain

    M. Ferrer

  4. Servei de Pneumologia i Al·lèrgia Respiratòria, Hospital Clínic, Barcelona, Spain

    A. Torres

Authors
  1. J. Almirall
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  2. A. Liapikou
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  3. M. Ferrer
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  4. A. Torres
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Corresponding author

Correspondence to A. Torres .

Editor information

Editors and Affiliations

  1. , Institute of Aging and Chronic Diseases, University Liverpool, Daulby Street, Liverpool, L69 3GA, United Kingdom

    Hendrick K.F. van Saene

  2. , Dept. Emergency, Hospital Gorizia, Via Vittorio Veneto 171, Gorizia, 34170, Italy

    Luciano Silvestri

  3. , Department of Intensive Care Medicine, Hospital Universitario de Getafe, Carretera de Toledo km 12.5, Getafe, 28045, Spain

    Miguel A. de la Cal

  4. Policlinico di Catania, UCO di Anestesia e Rianimazione, Azienda Ospedaliero-Universitaria, Via Santa Sofia 78, Catania, 95100, Italy

    Antonino Gullo

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Almirall, J., Liapikou, A., Ferrer, M., Torres, A. (2011). Lower Airway Infection. In: van Saene, H., Silvestri, L., de la Cal, M., Gullo, A. (eds) Infection Control in the Intensive Care Unit. Springer, Milano. https://doi.org/10.1007/978-88-470-1601-9_14

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  • DOI: https://doi.org/10.1007/978-88-470-1601-9_14

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  • Publisher Name: Springer, Milano

  • Print ISBN: 978-88-470-1600-2

  • Online ISBN: 978-88-470-1601-9

  • eBook Packages: MedicineMedicine (R0)

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