Mikrobiologische routinediagnostik auf ider intensivstation - Ein uptdate

Infectious diseases are a common problem in the intensive care unit. 33-53% of critically ill patients receive antibiotics while being treated in the ICU. The indication for the use of antimicrobial agents is based not only on the patient's clinical course but also on symptoms such as fever, leucocytosis, or the presence of elevated acute phase proteins. The identification of a pathogen is often a helpful adjunct in making a decision. Thus, the question arises whether it is useful to establish microbiological surveillance cultures as routine procedure in intensive care units. This article will present information on the rational use of urine, fecal and blood cultures as well as diagnostic measures of respiratory infections. In addition the relevance of screening for multiresistant pathogens is discussed in this update. A summary of available data demonstrates that prompt identification and therapy of an infection in critical ill patients is necessary to establish appropriate therapy, and early proof of the causative pathogen improves outcome. Nevertheless, it has not been shown yet that routine microbiological survillance is advantageous except for single indications. There is no firm evidence for the general proof of principle of this expensive procedure.