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Editorial |

Preventing Infections in the ICU:  One Size Does Not Fit All

Preeti N. Malani, MD, MSJ, MS1
[+] Author Affiliations
1Division of Infectious Diseases, Department of Internal Medicine, University of Michigan Health System, Veterans Affairs Ann Arbor Healthcare System, Ann Arbor. Dr Malani is also an Associate Editor, JAMA
JAMA. 2013;310(15):1567-1568. doi:10.1001/jama.2013.277816.
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Health care–associated infections remain an important and potentially modifiable source of morbidity and mortality in the intensive care unit (ICU). Notable successes in this arena have centered on “bundles” to prevent central line–associated bloodstream infection and ventilator-associated pneumonia.1,2 More recently, several studies have demonstrated the benefits of chlorhexidine bathing, both to prevent bloodstream infections and to decrease acquisition of drug-resistant organisms.3,4 The evidence for other measures is less clear, including active surveillance for antibiotic-resistant organisms and expanded contact precautions.5 Given the central role of the hands and clothing of health care workers in the spread of antibiotic-resistant organisms, the potential value of universal glove and gown use to prevent infection is intriguing, yet evidence to support this approach is lacking.

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