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KMID : 1201420140070020063
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Journal of Neurocritical Care
2014 Volume.7 No. 2 p.63 ~ p.70
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Diagnosis and Treatment of Nosocomial Infections in Neurological Intensive Care Units
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Choi Seong-Ho
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Abstract
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Patients admitted to neurological intensive care units are at increased risk for nosocomial infection, which may result in increased morbidity, mortality and financial costs. Altered mental status and mechanical ventilation predisposes patients to pneumonia. Early diagnosis and introduction of appropriate antimicrobial therapy may prevent a fatal outcome in patients with bacterial pneumonia. Modification of the initial antimicrobial therapy after several days, based on microbiologic culture results, prevents inappropriate therapy and selection of multi-drug resistant bacteria. Excessive and inadequate use of urinary catheter and central venous catheter (CVC) may result in catheter-associated urinary tract infection and CVC-related bloodstream infection. Early removal of catheters when no longer required may be the most important preventive measure. Postoperative bacterial meningitis (PBM) may occur in patients receiving brain surgery. Although PBM may not be easily differentiated from postoperative aseptic meningitis, early introduction of broad-spectrum antimicrobial agents may be required. Blood culture provides valuable information on the causative pathogen and its antimicrobial resistance to patients with serious nosocomial infection. Adherence to core principles of blood culture testing improves diagnosis and treatment of serious nosocomial infection.
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KEYWORD
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Nosocomial infection, Pneumonia, Urinary tract infections, Meningitis, Blood culture
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