Nosocomial Infection

37th Critical Care Congress: An Erupting Landscape: Nosocomial Pneumonia in the Age of Resistance
Supported by an educational grant from Ortho McNeil
Estimated running time: 1.5 hours
Credit Valid: March 2008-March 2009

Learning Objectives
At the conclusion of this activity, participants should be able to:

1. Determine the rationale of antimicrobial dosing strategies to optimize clinical outcomes and prevent resistance development
2. Identify viable therapeutic options for these difficult-to-treat infections
3. Discuss emerging epidemiological trends among noscomial gram negative bacilli

Target Audience
This continuing medical education offering is intended to meet the needs of any healthcare provider involved in the care of critically ill patients, including advance practice nurses, critical care nurses, intensivists, critical care fellows, anesthesiologists, internists, surgeons, cardiologists, pulmonologists, emergency medicine practitioners, neurologists, and respiratory therapists.

Obtaining Credit
Click here to complete the evaluation and credit verification.
Upon receipt, your certificate will be sent to you within 30 days.
If you have any questions, please contact the Continuing Education Department at 847-827-6869 or at education@sccm.org

Physicians/Physician Assistants
SCCM designates this educational activity for a maximum of 1.5 AMA PRA Category 1 CreditsTM. Physicians should claim credit commensurate with the extent of their participation in the activity.

Nurses
SCCM is approved by the California Board of Registered Nursing, Provider No. 8181, and the American Association of Critical-care Nurses (#00013930) and approves this activity for 1.5 contact hours.

Pharmacists
SCCM is accredited by the Accreditation Council for Pharmacy Education (ACPE) as a provider of continuing pharmaceutical education. This activity will provide 1.5 continuing education hours. (236-000-08-150-H01)


Faculty Disclosure Statement

Faculty reported the following disclosures for this activity:

Michael S. Niederman, MD, FCCM
Winthrop University Hospital
Mineola, New York, USA
Advisory Board: Johnson & Johnson, Pfizer, Schering, Merck, AstraZeneca, Theravance, Nektar

David Nicolau, PharmD
Hartford Hospital
Hartford, Connecticut, USA
Research Grant, Speakers Bureau: AstraZeneca, Merck, Johnson & Johnson, Wyeth, Cubist, Vertex, Astellas, Pfizer

Donald E. Craven, MD
Tufts University School of Medicine
Lahey Clinic Medical Center
Burlington, Massachusetts, USA
Honoraria, Speakers Bureau: Pfizer, Elan, Sanofi Pasteur, Wyeth, Arpida, Cubist, Merck; Research Grants: Bard Data
and Safety Monitoring Board, Johnson & Johnson; Consultant: Wyeth, Bayer, Nektar, Cubist

• Michael S. Niederman, MD, FCCM,  discusses emerging epidemiological trends among nosocomial gram-negative bacilli
• David Nicolau PharmD presents the rationale of antimicrobial dosing strategies to optimize clinical outcomes and prevent resistance development
• Donald E. Craven, MD Identifies viable therapeutic options for these difficult-to-treat infections
  
  To hear the complete presentation, click here

36th Critical Care Congress:  The Latest in Nosocomial Infections

• Marin Kollef, MD, discusses ventilator-associated pneumonia (VAP) and various prevention techniques such as coated endotracheal tubes, intravenous and topical antibiotics, and oral decontamination methods.
• Dennis Maki, MD, evaluates controversial catheter maintenance to prevent bloodstream infections; 
• Jean Chastre, MD, compares the benefits and limitations of clinical strategies versus quantitative strategies in the diagnosis of VAP  
• J. Victor Ryckman, MD, describes wound infections and protocols for preventio in surgical patients 
• May Lou Sole, PhD, RN, CCNS, FAAN, explores the nurse’s role in infection prevention, the need for a team approach, educational integration, and the use of bundles   To hear the complete presentation, click here.

Guidelines

Guidelines for the management of intravascular catheter-related infections
Clin Inf Dis 2001;32:1249-1272

Guidelines for the prevention of intravascular catheter-related infections
MMWR 2002;1(RR-10):1-29

Publications

Antibiotic therapy in Critical Illness. Multiprofessional Critical Care Review Course. 2005

The ICU clinician is confronted on a regular basis with 2 conflicting goals of practice: 1) initiating effective antimicrobial therapy early to minimize infection-related morbidity and mortality, and 2) minimizing antimicrobial use to reduce the incidence of antimicrobial resistance.  The most immediate consequences of flawed antimicrobial practices are the increased morbidity/mortality, superinfection with multi- or even pan-resistant organisms, serious toxicity, antibiotic-related colitis, and increased direct and in direct health care costs. Indeed, although there are now more approved antimicrobials than ever before, at many tertiary-care and academic centers fewer antimicrobial choices are “at the bedside” due to the rising incidence of multiresistant gram-positive and gram-negative organisms. 
     
Click here to view the entire chapter of Antibiotic Therapy in Critical Illness. 

For more information on caring for the critically ill and injured patients, the publication Multiprofessional Critical Care Review Course is available for purchase from the Society of Critical Care Medicine.  Click here for details or to add to your shopping cart.

Critical Connections Articles

Catheter-Related Bloodstream Infections: Can We Make It Safer For Our Patients? 
April 2006, Critical Connections

Contemporary Antimicrobial Focus in Critical Illness: MRSA and Fungi
April 2006, Critical Connections


 

  SCCM Pod-62 Simple Measures Can Decrease Catheter-Related Bloodstream Infections
Peter Pronovost, MD, PhD, FCCM, discusses his article published in the December 28 issue of the New England Journal of Medicine, titled "An Intervention to Decrease Catheter-Related Bloodstream Infections in the ICU." Dr. Pronovost and researchers showed through this study that simple measures, such as hand washing, can have a dramatic effect in reducing bloodstream infections. They focused on improved teamwork between doctors, nurses and other intensive care unit professionals, collecting data from 103 Michigan hospitals for up to 18 months. The reference for this article is NEJM 2006 Volume 355, Number 26:2725-2732.

  SCCM Pod-40 CCM: Initial Antimicrobial Treatment of MRSA
Marin Kollef, MD, professor of medicine in the department of pulmonary and critical care medicine at the Washington University School of Medicine and director of medical critical care at Barnes-Jewish Hospital, discusses his article in the August issue of Critical Care Medicine, "Methicillin-Resistant Staphylococcus aureus Sterile-Site Infection: The Importance of Appropriate Initial Antimicrobial Treatment." (Crit Care Med; 2006, 34(8):2069-2074)

  SCCM Pod-32 CC: Catheter-Related Bloodstream Infections
Vera De Palo, MD, outlines several common questions healthcare professionals should consider to help prevent catheter-related bloodstream infections in the ICU. Her article "Catheter-Related Bloodstream Infections: Can We Make it Safer For Our Patients?" appears in the April issue of Critical Connections. Dr. DePalo is associate chief of medicine and director of critical care at Memorial Hospital of Rhode Island. She also is an associate professor of medicine at Brown Medical School. (Crit Conn 2006 Vol.5 No.2)