CHAI Wenzhao, LIU Jingjing, WANG Xiaoting, MA Xiaojun, TANG Bo, ZHANG Qing, WANG Bin, WANG Xiaomeng, ZHU Shihong, CHEN Wenjin, CHEN Zujun, YANG Quanhui, YANG Rongli, DING Xin, ZHAO Hua, CHENG Wei, DUNA Jun, GAO Jingli, LIU Dawei. 2024 Expert Consensus on Hospital Acquired Infection Control Principles in the Department of Critical Care Medicine[J]. Medical Journal of Peking Union Medical College Hospital, 2024, 15(3): 522-531. DOI: 10.12290/xhyxzz.2024-0301
Citation: CHAI Wenzhao, LIU Jingjing, WANG Xiaoting, MA Xiaojun, TANG Bo, ZHANG Qing, WANG Bin, WANG Xiaomeng, ZHU Shihong, CHEN Wenjin, CHEN Zujun, YANG Quanhui, YANG Rongli, DING Xin, ZHAO Hua, CHENG Wei, DUNA Jun, GAO Jingli, LIU Dawei. 2024 Expert Consensus on Hospital Acquired Infection Control Principles in the Department of Critical Care Medicine[J]. Medical Journal of Peking Union Medical College Hospital, 2024, 15(3): 522-531. DOI: 10.12290/xhyxzz.2024-0301

2024 Expert Consensus on Hospital Acquired Infection Control Principles in the Department of Critical Care Medicine

Funds: 

The Science and Technology Plan Project of Beijing Z201100005520038

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  • Corresponding author:

    LIU Dawei, E-mail: dwliu98@163.com

  • Received Date: May 07, 2024
  • Accepted Date: May 29, 2024
  • Issue Publish Date: May 29, 2024
  • Critically ill patients are at high risk for hospital acquired infections, which can significantly increase the mortality rate and treatment costs for these patients. Therefore, in the process of treating the primary disease, strict prevention and control of new hospital infections is an essential component of the treatment for critically ill patients. The treatment of critically ill patients involves multiple steps and requires a concerted effort from various aspects such as theory, management, education, standards, and supervision to achieve effective prevention and control of hospital infections. However, there is currently a lack of unified understanding and standards for hospital infection prevention and control. To address this, in March 2024, a group of experts in critical care medicine, infectious diseases, and hospital infection from China discussed the current situation and issues of hospital infection control in the intensive care unit together. Based on a review of the latest evidence-based medical evidence from both domestic and international sources, 2024 Expert Consensus on Hospital Acquired Infection Control Principles in the Department of Critical Care Medicine was formed, aiming to provide a basis for the development of hospital infection prevention and control strategies in the field of critical care medicine.

  • [1]
    Blot S, Ruppé E, Harbarth S, et al. Healthcare-associated infections in adult intensive care unit patients: changes in epidemiology, diagnosis, prevention and contributions of new technologies[J]. Intensive Crit Care Nurs, 2022, 70: 103227. DOI: 10.1016/j.iccn.2022.103227
    [2]
    GBD 2019 Antimicrobial Resistance Collaborators. Global mortality associated with 33 bacterial pathogens in 2019: a systematic analysis for the Global Burden of Disease Study 2019[J]. Lancet, 2022, 400(10369): 2221-2248. DOI: 10.1016/S0140-6736(22)02185-7
    [3]
    国家卫生健康委员会. 中国抗菌药物管理和细菌耐药现状报告(2019)[R]. 北京: 中国协和医科大学出版社, 2019.

    National Health Commission of the People's Republic of China. Status report on antimicrobial administration and antimicrobial resistance in China (2019)[R]. Beijing: China Union Medical College Press, 2019.
    [4]
    Vincent J L. Nosocomial infections in adult intensive-care units[J]. Lancet, 2003, 361(9374): 2068-2077. DOI: 10.1016/S0140-6736(03)13644-6
    [5]
    Fridkin S K, Welbel S F, Weinstein R A. Magnitude and prevention of nosocomial infections in the intensive care unit[J]. Infect Dis Clin North Am, 1997, 11(2): 479-496. DOI: 10.1016/S0891-5520(05)70366-4
    [6]
    Gikas A, Roumbelaki M, Bagatzouni-Pieridou D, et al. Device-associated infections in the intensive care units of Cyprus: results of the first national incidence study[J]. Infection, 2010, 38(3): 165-171. DOI: 10.1007/s15010-010-0007-2
    [7]
    Burgmann H, Hiesmayr J M, Savey A, et al. Impact of nosocomial infections on clinical outcome and resource consumption in critically ill patients[J]. Intensive Care Med, 2010, 36(9): 1597-1601. DOI: 10.1007/s00134-010-1941-2
    [8]
    Kollef M H, Torres A, Shorr A F, et al. Nosocomial infection[J]. Crit Care Med, 2021, 49(2): 169-187. DOI: 10.1097/CCM.0000000000004783
    [9]
    Lewis S R, Schofield-Robinson O J, Rhodes S, et al. Chlorhexidine bathing of the critically ill for the prevention of hospital-acquired infection[J]. Cochrane Database Syst Rev, 2019, 8(8): CD012248.
    [10]
    Zhao T T, Wu X Y, Zhang Q, et al. Oral hygiene care for critically ill patients to prevent ventilator-associated pneumonia[J]. Cochrane Database Syst Rev, 2020, 12(12): CD008367.
    [11]
    Zahar J R, Lucet J C, Timsit J F. Antimicrobial resistance in intensive care units[J]. Lancet Infect Dis, 2014, 14(1): 3-5. DOI: 10.1016/S1473-3099(13)70305-0
    [12]
    Huang S S, Septimus E, Kleinman K, et al. Targeted versus Universal decolonization to prevent ICU infection[J]. N Engl J Med, 2013, 368(24): 2255-2265. DOI: 10.1056/NEJMoa1207290
    [13]
    Huang S S, Septimus E J, Kleinman K, et al. Nasal iodophor antiseptic vs nasal mupirocin antibiotic in the setting of chlorhexidine bathing to prevent infections in adult ICUs: a randomized clinical trial[J]. JAMA, 2023, 330(14): 1337-1347. DOI: 10.1001/jama.2023.17219
    [14]
    Strich J R, Palmore T N. Preventing transmission of multidrug-resistant pathogens in the intensive care unit[J]. Infect Dis Clin North Am, 2017, 31(3): 535-550. DOI: 10.1016/j.idc.2017.05.010
    [15]
    Derde L P G, Cooper B S, Goossens H, et al. Interventions to reduce colonisation and transmission of antimicrobial-resistant bacteria in intensive care units: an interrupted time series study and cluster randomised trial[J]. Lancet Infect Dis, 2014, 14(1): 31-39. DOI: 10.1016/S1473-3099(13)70295-0
    [16]
    Nasr P. Genetics, epidemiology, and clinical manifestations of multidrug-resistant Acinetobacter baumannii[J]. J Hosp Infect, 2020, 104(1): 4-11. DOI: 10.1016/j.jhin.2019.09.021
    [17]
    Chinese XDR Consensus Working Group. Laboratory diagnosis, clinical management and infection control of the infections caused by extensively drug-resistant Gram-negative bacilli: a Chinese consensus statement[J]. Clin Microbiol Infect, 2016, 22(Suppl 1): S15-S25.
    [18]
    Giamarellou H. Multidrug-resistant Gram-negative bacteria: how to treat and for how long[J]. Int J Antimicrob Agents, 2010, 36(Suppl 2): S50-S54.
    [19]
    Lancet Infectious Diseases. Antimicrobial resistance: the Hydra among us[J]. Lancet Infect Dis, 2015, 15(11): 1243. DOI: 10.1016/S1473-3099(15)00363-1
    [20]
    O'Grady N P, Alexander M, Burns L A, et al. Guidelines for the prevention of intravascular catheter-related infections[J]. Clin Infect Dis, 2011, 52(9): e162-e193. DOI: 10.1093/cid/cir257
    [21]
    Noto M J, Domenico H J, Byrne D W, et al. Chlorhexidine bathing and health care-associated infections: a randomized clinical trial[J]. JAMA, 2015, 313(4): 369-378. DOI: 10.1001/jama.2014.18400
    [22]
    Harris-Tryon T A, Grice E A. Microbiota and maintenance of skin barrier function[J]. Science, 2022, 376(6596): 940-945. DOI: 10.1126/science.abo0693
    [23]
    Odada D, Munyi H, Gatuiku J, et al. Reducing the rate of central line-associated bloodstream infections; a quality improvement project[J]. BMC Infect Dis, 2023, 23(1): 745. DOI: 10.1186/s12879-023-08744-5
    [24]
    Timsit J F, Baleine J, Bernard L, et al. Expert consensus-based clinical practice guidelines management of intravas-cular catheters in the intensive care unit[J]. Ann Intensive Care, 2020, 10(1): 118. DOI: 10.1186/s13613-020-00713-4
    [25]
    Papazian L, Klompas M, Luyt C E. Ventilator-associated pneumonia in adults: a narrative review[J]. Intensive Care Med, 2020, 46(5): 888-906. DOI: 10.1007/s00134-020-05980-0
    [26]
    陆英金, 唐运姣, 雷丽芳. 无针密闭输液接头在重症病人的应用研究进展[J]. 保健文汇, 2021, 22(9): 252-253.

    Lu Y J, Tang Y J, Lei L F. Research progress on the application of needle free sealed infusion connectors in critically ill patients[J]. Health Lit, 2021, 22(9): 252-253.
    [27]
    Amavasi B, Zimmerman P A. Infection prevention and control continuous education and training in pre-registration nursing programmes[J]. Nurse Educ Today, 2024, 133: 106051. DOI: 10.1016/j.nedt.2023.106051
    [28]
    Tsioutis C, Birgand G, Bathoorn E, et al. Education and training programmes for infection prevention and control professionals: mapping the current opportunities and local needs in European countries[J]. Antimicrob Resist Infect Control, 2020, 9(1): 183. DOI: 10.1186/s13756-020-00835-1
    [29]
    Dergousoff B A, Vayalumkal J V, Wright N A M. Survey of infection control precautions for patients with severe combined immune deficiency[J]. J Clin Immunol, 2019, 39(8): 753-761. DOI: 10.1007/s10875-019-00671-y
    [30]
    Mazuel M, Moulier V, Bourrel A S, et al. Systematic culture of central catheters and infections related to catheters in a neonatal intensive care unit: an observational study[J]. Sci Rep, 2024, 14(1): 8647. DOI: 10.1038/s41598-024-59371-2
    [31]
    Schuttevaer R, Brink A, Alsma J, et al. The association of body temperature with antibiotic therapy and mortality in patients attending the emergency department with suspected infection[J]. Eur J Emerg Med, 2021, 28(6): 440-447. DOI: 10.1097/MEJ.0000000000000817
    [32]
    Kushimoto S, Gando S, Saitoh D, et al. The impact of body temperature abnormalities on the disease severity and outcome in patients with severe sepsis: an analysis from a multicenter, prospective survey of severe sepsis[J]. Crit Care, 2013, 17(6): R271. DOI: 10.1186/cc13106
    [33]
    Wu Y F, Wang Y Q, Yang H M, et al. Resident bacteria contribute to opportunistic infections of the respiratory tract[J]. PLoS Pathog, 2021, 17(3): e1009436. DOI: 10.1371/journal.ppat.1009436
    [34]
    Kadioglu A, Weiser J N, Paton J C, et al. The role of Streptococcus pneumoniae virulence factors in host respiratory colonization and disease[J]. Nat Rev Microbiol, 2008, 6(4): 288-301. DOI: 10.1038/nrmicro1871
    [35]
    Siegel S J, Weiser J N. Mechanisms of bacterial colonization of the respiratory tract[J]. Annu Rev Microbiol, 2015, 69: 425-444. DOI: 10.1146/annurev-micro-091014-104209
    [36]
    Sharma L, Feng J J, Britto C J, et al. Mechanisms of epithelial immunity evasion by respiratory bacterial pathogens[J]. Front Immunol, 2020, 11: 91. DOI: 10.3389/fimmu.2020.00091
    [37]
    Czarnowski M, Słowińska M, Sawieljew M, et al. Efficacy of ceragenins in controlling the growth of oral microorganisms: implications for oral hygiene management[J]. Pharmaceuticals (Basel), 2024, 17(2): 204. DOI: 10.3390/ph17020204
    [38]
    Engel H J, Brummel N E. What exactly is recommended for patient physical activity during an ICU stay?[J]. Crit Care Med, 2024, 52(5): 842-847. DOI: 10.1097/CCM.0000000000006233
    [39]
    Aggarwal N, Kitano S, Puah G R Y, et al. Microbiome and human health: current understanding, engineering, and enabling technologies[J]. Chem Rev, 2023, 123(1): 31-72. DOI: 10.1021/acs.chemrev.2c00431
    [40]
    Willing B P, Russell S L, Finlay B B. Shifting the balance: antibiotic effects on host-microbiota mutualism[J]. Nat Rev Microbiol, 2011, 9(4): 233-243. DOI: 10.1038/nrmicro2536
    [41]
    Sommer M O A, Dantas G, Church G M. Functional characterization of the antibiotic resistance reservoir in the human microflora[J]. Science, 2009, 325(5944): 1128-1131. DOI: 10.1126/science.1176950
    [42]
    Smith W P J, Wucher B R, Nadell C D, et al. Bacterial defences: mechanisms, evolution and antimicrobial resistance[J]. Nat Rev Microbiol, 2023, 21(8): 519-534. DOI: 10.1038/s41579-023-00877-3
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