Management of Bacterial and Fungal Infections in the ICU: Diagnosis, Treatment, and Prevention Recommendations

Timothy M Rawson; David B Antcliffe; Richard C Wilson; Alireza Abdolrasouli; Luke S P Moore

doi:10.2147/IDR.S390946

Management of Bacterial and Fungal Infections in the ICU: Diagnosis, Treatment, and Prevention Recommendations

Infect Drug Resist. 2023 May 4:16:2709-2726. doi: 10.2147/IDR.S390946. eCollection 2023.

Authors

Timothy M Rawson^{1

2

3}, David B Antcliffe^{2

4}, Richard C Wilson^{1

2

3}, Alireza Abdolrasouli⁵, Luke S P Moore^{1

6

7}

Affiliations

¹ Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance, Hammersmith Hospital, London, UK.
² Centre for Antimicrobial Optimisation, Imperial College London, Imperial College London, London, UK.
³ David Price Evan's Group in Infectious Diseases and Global Health, Department of Pharmacology and Therapeutics, University of Liverpool, Liverpool, UK.
⁴ Division Anaesthesia, Pain Medicine and Intensive Care, Department of Surgery and Cancer, Imperial College London, London, UK.
⁵ Department of Medical Microbiology, King's College Hospital, London, UK.
⁶ Chelsea & Westminster NHS Foundation Trust, London, UK.
⁷ North West London Pathology, Imperial College Healthcare NHS Trust, London, UK.

Abstract

Bacterial and fungal infections are common issues for patients in the intensive care unit (ICU). Large, multinational point prevalence surveys have identified that up to 50% of ICU patients have a diagnosis of bacterial or fungal infection at any one time. Infection in the ICU is associated with its own challenges. Causative organisms often harbour intrinsic and acquired mechanisms of drug-resistance, making empiric and targeted antimicrobial selection challenging. Infection in the ICU is associated with worse clinical outcomes for patients. We review the epidemiology of bacterial and fungal infection in the ICU. We discuss risk factors for acquisition, approaches to diagnosis and management, and common strategies for the prevention of infection.

Keywords: bacterial infection; critical care; diagnostics; fungal infection; therapeutics.

Publication types

Review