Infection Control in the ICU Environment (Perspectives on Critical Care Infectious Diseases Book 5)

__Infection Control in the ICU Environment__ provides the details of the most common infection control problems facing intensive care units. Authors include noted scientists, intensivists and epidemiologists from the United States and Europe as well as infection control experts from the Centers for Disease Control and Prevention. Acinetobacter, methicillin resistant staphylococcus aureus and vancomycin resistant enterococci are examined in detail. This volume also includes cutting edge information regarding the potential for prophylactic and pre-emptive therapy of fungal infections in intensive care units. Innovations in vascular catheter care and prevention of bloodstream infections are discussed in this volume as well as the newest information in mathematical modeling to understand the epidemiology and control of infections in intensive care units.

Severe Community Acquired Pneumonia is a book in which chapters are authored and the same topics discussed by North American and European experts. This approach provides a unique opportunity to view the different perspectives and points of view on this subject. Severe CAP is a common clinical problem encountered in the ICU setting. This book reviews topics concerning the pathogenesis, diagnosis and management of SCAP. The discussions on the role of alcohol in severe CAP and adjunctive therapies are important topics that further our understanding of this severe respiratory infection.

Doody Review Services

Reviewer:David J. Dries, MD(University of Minnesota Medical School)
Description:This monograph describes management of community acquired pneumonia. Etiologic considerations, general management principles and specific clinical strategies are special matters discussed in the book's 11 chapters.
Purpose:One of a series of updates on therapy for controversial topics and infectious problems within critical illness is provided.
Audience:Practitioners and senior trainees in critical care medicine are an appropriate audience for this work. Editors and authors represent international authorities in management of pulmonary diseases.
Features:Management principles and treatment of specific problem organisms are first discussed. Alcohol as an etiologic factor for community acquired pneumonia and adjunctive therapies are discussed in four concluding chapters. Presentation in chapters is terse with texture of type dividing major subheadings. Tables are occasionally employed, but there are no other illustrations. Chapters contain an appropriate reference list. In many cases, references date to within one to year of publication. The table of contents includes only chapter title and authorship while an index of four pages organized according to subjects concludes.
Assessment:This book suffers initially from the lack of a stated objective. For example, contributors do not discern intellectual boundaries for community acquired pneumonia as opposed to that which may be seen elsewhere and at other times in the critical care unit. Issues of diagnosis and an algorithm of graduated support with mechanical ventilation are incompletely developed. Other chapters, such as those describing the pathophysiology of alcohol as a risk factor for pneumonia, offer a worthwhile collection of data and insight. Disease state definition and principles of antimicrobial therapy could be added to a subsequent edition describing this problem.

Front Matter....Pages i-xi Scope and Magnitude of Nosocomial ICU Infections....Pages 1-13 Scope and Magnitude of Nosocomial ICU Infections....Pages 15-31 Vancomycin-Resistant Enterococci: A Threat for the ICU?....Pages 33-47 Vancomycin-Resistant Enterococci in Europe: A Changing Epidemiology?....Pages 49-56 Methicillin-Resistant Staphylococcus Aureus: Is Control Necessary?....Pages 57-65 Acinetobacter: Epidemiology and Control....Pages 67-76 Acinetobacter: Epidemiology and Control....Pages 77-91 Fungal Infections: The Role of Prophylactic and Empiric Antifungal Therapy in ICU Patients....Pages 93-105 Fungal Infections: The Role of Prophylaxis and Empiric Therapy in ICU Patients....Pages 107-114 Newer Approaches to Preventing Vascular Catheter-Related Sepsis....Pages 115-128 Newer Approaches to Preventing Intravascular Device-Related Bloodstream Infections....Pages 129-140 Is Prevention of Ventilator-Associated Pneumonia Cost Effective....Pages 141-153 Ventilator-Associated Pneumonia: Is Prevention Cost-Effective?....Pages 155-167 Cross-Colonization in Intensive Care Units: Fact or Fiction?....Pages 169-180 Cross-Colonization: Fact or Fiction?....Pages 181-193 Conventional Infection Control Measures: Value or Ritual?....Pages 195-211 Conventional Infection Control Measures: Value or Ritual?....Pages 213-229 Modeling of Antibiotic Resistance in the ICU....Pages 231-243 Mathematical Models in the ICU: Dynamics, Infection Control and Antibiotic Resistance....Pages 245-266 Back Matter....Pages 267-276 Machine Generated Contents Note: I Diagnosis Of Pneumonia -- Jean-yves Fagon And Jean Chastre -- 2, Diagnosis Of Ventilator-associated Pneumonia -- One American's Perspective -- Michael S. Niedenran -- Prevention Of Pneumonia In Mechanically -- Ventilated Patients -- Jordi Valles -- 4, Is Prevention Of Ventilator-associated Pneumonia -- Cost Effective? -- Marin H. Kollef -- Role Of The Oropharynx And Digestive Tract In -- The Pathogenesis Of Ventilator-associated Pneumonia -- Christianne A. Van Nieuwenhoven And -- Marc J.m. Bonten -- B;6. Treatment Of Ventilator-associated Pneumonia -- European Perspective. -- 1. Sole-violan, And -- F. Rodriguez De Castro -- 7. Treatment Of Ventilator-associated Pneumonia -- North American Perspective: -- Richard G. Wunderink -- 8. Resistant Pathogens: Emergence And Control -- In Icu Patients -- Jean Chastre -- 9. Resistant Pathogens: Emergence And Control -- Patricia Winokur, Carol E. Chenoweth, Louis Rice, -- Borna Mehrad, And Joseph P. Lynch, Iii -- 10. Mortality And Morbidity Of Ventilator-associated -- Pneumonia: The Controversy -- Jean Carlet, Jean-francois Timsit, Benoit Misset, -- M. Garrouste, And L. Soufir -- Index. Edited By Richard G. Wunderink, Jordi Rello. Includes Bibliographical References And Index. Much research over the past 30 to 40 years has shown that the inflammatory response, while critical for host defense during microbial infection, may itself play a central role in the pathogenesis of sepsis. Although key mediators responsible for this injury have been identified, efforts clinically to augment our conventional antimicrobial and supportive therapies during sepsis with agents modulating the inflammatory response have been unsuccessful. As a result, the mortality associated with this lethal syndrome, especially when complicated by shock, has remained persistently high. Unfortunately, during this same period of time, the incidence of sepsis has accelerated as other fields of medicine have relied increasingly on therapies that predispose to infection. While frustrating, overall this experience in the field of sepsis has not been without value. Most importantly, it has helped define on several different levels the complexity of the septic patient. Recognizing and addressing this complexity as discussed by each of the contributors to Evolving Concepts in Sepsis and Septic Shock may now provide new inroads into the treatment of sepsis.

Infection Control in the ICU Environment provides the details of the most common infection control problems facing intensive care units. Authors include noted scientists, intensivists and epidemiologists from the United States and Europe as well as infection control experts from the Centers for Disease Control and Prevention.
Acinetobacter, methicillin resistant staphylococcus aureus and vancomycin resistant enterococci are examined in detail. This volume also includes cutting edge information regarding the potential for prophylactic and pre-emptive therapy of fungal infections in intensive care units.
Innovations in vascular catheter care and prevention of bloodstream infections are discussed in this volume as well as the newest information in mathematical modeling to understand the epidemiology and control of infections in intensive care units.

Infectious Complications in Transplant Patients has been uniquely designed and formatted to address issues and trends pertaining to pathogens deemed important in critically ill transplant patients. The chapters have been carefully selected so as to direct the focus of the book towards current approaches to controversial, emerging or topical problems in these patients.
Each chapter has been authored by a North American and a European specialist. This format serves to impart an added dimension reflective of the diversity of opinions and practices pertaining to unresolved or controversial issues. The authors are recognized experts in their respective fields.

Ventilator-associated pneumonia (VAP) continues to be one of the greatest challenges to critical care practitioners and one of the greatest threats to the survival of our patients. The choice of this topic for an issue of the PERSPECTIVES IN CRITICAL CARE INFECTIOUS DISEASES Series is therefore quite appropriate. Despite its importance, many areas of the management of ventilator-associated pneumonia remain controversial. We therefore are pleased to include contributions from experts and investigators offering different perspectives on some of these controversial areas. As stated in a recent editorial (1): "the diagnosis of nosocomial pneumonia has long been a subject of disagreement, with some intensivists relying on the use of bronchoscopic data to define the presence of lung infection and the responsible organisms, whereas others have used a combination of clinical diagnosis and tracheal aspirate cultures to achieve the same ends (2,3)". Infection transmitted by a cadaveric donor organ can result not only in a loss of the recipient's allograft, but also in death of the immunosuppressed patient. Intensive care units (ICUs) are a primary component of modern medicine and are currently in more than 95% of acute-care hospitals in the United States. Edited By Peter Q. Eichacker And Jérôme Pugin. Includes Bibliographical References And Index.