[Infection Prevention in the Intensive Care Unit: Evidence-Based Strategies for Reducing Healthcare-Associated Infections].

Abstract

Abstract: Healthcare-associated infections (HAIs) remain among the most frequent and preventable complications in intensive care units (ICUs), contributing substantially to morbidity, mortality, prolonged length of stay, and healthcare costs. This review summarizes current evidence-based strategies for infection prevention in critical care settings, focusing on key domains including hand hygiene, prevention of ventilator-associated pneumonia (VAP), central line-associated bloodstream infections (CLABSI), and catheter-associated urinary tract infections (CAUTI).ICUs represent a high-risk environment due to the frequent use of invasive devices, high patient acuity, and complex care processes. Device-associated infections account for a large proportion of HAIs, with incidence rates remaining significant despite advances in care. Hand hygiene remains the single most effective preventive measure, yet compliance is often suboptimal, particularly in high-intensity settings. The appropriate use of gloves as an adjunct, not a substitute, for hand hygiene is critical.Multimodal prevention strategies, particularly structured care bundles, have demonstrated significant reductions in infection rates when consistently implemented. Key interventions include elevation of the head of the bed, daily sedation interruption, early mobilization, aseptic catheter insertion techniques, and strict adherence to maintenance protocols. Daily reassessment of device necessity is among the most effective measures to reduce infection risk.Antimicrobial stewardship and targeted microbiological diagnostics are integral components of infection prevention, reducing unnecessary antibiotic exposure and limiting the emergence of multidrug-resistant organisms. Additionally, digital tools such as automated surveillance systems and predictive analytics offer emerging opportunities to enhance early detection, monitoring, and individualized prevention strategies.Sustainable infection prevention requires a multidisciplinary approach, combining structured protocols, regular staff training, continuous feedback, and strong leadership support. Ultimately, consistent implementation of evidence-based measures can significantly improve patient safety and reduce the burden of HAIs in intensive care.