[Surveillance and control of infections in the intensive care unit: rates, resistance, and carrier state]

Abstract

The nosocomial infection detection systems in Intensive Care Units, present certain peculiarities. The traditional methods, the most important example of which is the National Nosocomial Infections System, have, among their most explicit main objectives, the comparison of the number of infections, and the infectious flora between Units, and within the same Unit, over a period of time. For this reason, they are experiencing a great development within the hospitality quality control programs. In the last decade, the control of the flora of the digestive apparatus, the oropharynx, and the rectum of ICU patients, has permitted the making of an etiopathogenic classification of the infections (primary endogenous, secondary endogenous, and exogenous), which has justified the use of preventive measures with topical and systemic antimicrobial agents, according to the cases, with a tremendous impact on the decrease in the number of pneumonia's associated with mechanical ventilation, and of early pneumonia's which traditionally are excluded from the traditional detectional systems, as well as the control of multiresistant gram-negative bacilli. For this reason, it is recommended that both methods be complementary to each other. Neither of the two detection systems has been evaluated in terms of efficiency.