Infection Control in the Intensive Care Unit

Intensive care is a rapidly changing area of medicine, and after four years from the 2nd edition the volume editors and authors have deemed necessary to update it. In the recent years, in fact, five new randomised controlled trials and five new meta-analyses demonstrate that selective decontamination of the digestive tract [SDD] is an antimicrobial prophylaxis to prevent severe infections of not only lower airways but also of blood. Additionally, SDD has been shown to reduce inflammation including multiple organ failure and mortality. An intriguing observation is the evidence that SDD using parenteral and enteral antimicrobials reduces rather than increases antimicrobial resistance. Moreover, a new chapter on microcirculation had been added. The volume will be an invaluable tool for all those requiring in depth knowledge in the ever expanding field of infection control.

Hendrik van Saene studied medicine at the University of Leuven (Belgium), and was awarded an M.D. in 1973. He trained and qualified as a medical microbiologist at the University of Groningen (The Netherlands) in 1977. His most recent clinical research involves the administration of enteral vancomycin to control MRSA pneumonia and outbreaks (European Respiratory Journal 2004; 23: 921-926; Journal of Hospital Infection 2004; 56: 175-183; Annals of Surgery 2007; 245: 397-407). Dr van Saene has been awarded European research prizes, the Fellowship of the Royal College of Pathologists, Merit Awards and Readership for his infection prevention work using selective decontamination. The validity of this strategy has been confirmed in individual trials and recent meta-analyses showing a significant reduction in overall mortality by 8% and a relative reduction by 29% (American Journal of Respiratory and Critical Care Medicine 2002; 166: 1029-1037; Lancet 2003; 362: 1011-1016; The Cochrane Library, Issue 1, Chichester, UK: John Wiley & Sons Ltd. 2004; Journal of Critical Care 2009; in press). During the last four years, Dr Silvestri and he meta-analysed all randomised controlled trials on SDD, in five different meta-analyses. He is the author and/or co-author of 300 publications, of which approximately 200 are available on the internet.Dr. Miguel de la Cal is responsible for the ICU Unit of the Santa Coruna Hospital in Madrid and Dr. Luciani Silvestri is in charge of the Unit of Anesthesia and Resuscitation of the Gorizia Hospital. They have cooperated also on the previous editions of the volume.