Nosocomial pneumonia in critically ill patients

Abstract

The care of critically ill patients in the intensive care unit (ICU) is a primary component of modern medicine. ICUs create potential for recovery in patients who otherwise may not have survived. However, they may suffer from problems associated with of nosocomial infections. Nosocomial infections are those which manifest in patients 48 hours after admission to hospital. Nosocomial infections are directly related to diagnostic, interventional or therapeutic procedures a patient undergoes in hospital, and are also influenced by the bacteriological flora prevailing within a particular unit or hospital. Urinary tract infections are the most frequent nosocomial infection, accounting for more than 40% of all nosocomial infections. Critical care units increasingly use high technology medicine for patient care, hemodynamic monitoring, ventilator support, hemodialysis, parenteral nutrition, and a large battery of powerful drugs, particularly antibiotics to counter infection. It is indeed a paradox that the use of high-tech medicine has brought in its wake the dangerous and all too frequent complication of nosocomial infections.

Keywords: Hospital acquired pneumonia; nosocomial pneumonia; ventilator associated pneumonia.

Figure 1

Cycle of transmission of nosocomial pneumonia. (Courtesy: Faroch Erach udwadia Editor, Textbook of Priciples of Critical Care, Chapter 13.2, NSOCO. Mail Infections published by Oxford University Press, New Delhi, 2nd Edition, 2005 P 384.)