Emerging multiresistant organisms in the ICU: epidemiology, risk factors, surveillance, and prevention.

Recent cases of vancomycin-resistant enterococcus (VRE) at our facility and the emergence of new vancomycin intermediate resistant strains of bacteria provided the impetus for this discussion on superbugs. Each year approximately two million patients develop an infection after receiving health care in a United States hospital. These infections are often difficult to treat because the microorganisms most frequently involved are resistant to current antibiotic therapy. The result is increased morbidity, mortality, and health care costs. The recent development of intermediate resistant strains of bacteria is indeed an ominous indicator of what the future might hold for the health care profession should our current practices go on unchecked. This article will present an overview of the epidemiology of these multiresistant organisms, risk factors inherent to the intensive care environment, nursing responsibilities, and the rationale for surveillance protocols.