TY - CHAP M1 - Book, Section TI - Chapter 35. Principles of Antimicrobial Use in Critical Care A1 - Osinusi, Anu A1 - Joshi, Manjari A2 - Farcy, David A. A2 - Chiu, William C. A2 - Flaxman, Alex A2 - Marshall, John P. PY - 2012 T2 - Critical Care Emergency Medicine AB - Critically ill patients are at very high risk of developing severe infections, with incidence rates typically about 5- to 10-fold higher than general wards. Estimates from the National Nosocomial Infections Surveillance (NNIS, now the National Healthcare Safety Network [NHSN]) system demonstrated that approximately 1.7 million nosocomial infections occurred in US hospitals in 2002. Twenty-four percent of these infections occurred in the intensive care unit (ICU), a rate of 13 per 1,000 patient days,1 while other studies have demonstrated incidence rates between 9% and 37%.2,3 Critically ill patients have numerous insults to normal host mechanisms. Skin integrity is usually compromised by peripheral and central access devices or wounds. Certain immunosuppressive medications decrease the ability of the immunologic defenses to function properly. Furthermore, other underlying medical conditions, such as diabetes, malnutrition, and renal disease, may predispose patients to infectious complications. SN - PB - The McGraw-Hill Companies CY - New York, NY Y2 - 2024/03/28 UR - accessemergencymedicine.mhmedical.com/content.aspx?aid=55814146 ER -