ABSTRACT
Hospital nosocomial (hospital acquired infection – HAI) rates remain 8-10 per cent (Emmerson, 1997); one-third are preventable (Bion et al., 2001), one-third are acquired in ICUs (Eggimann & Pittet, 2001). Infection can be endogenous or exogenous. Half of the patients admitted to an ICU are already colonised by micro-organisms that will cause subsequent infections (Eggimann & Pittet, 2001), and one in 20 ICU patients develop bloodstream infections (Laupland et al., 2002). Endogenous infection, from organisms already harboured by patients, in the ICU usually occurs through the respiratory tract (e.g. ventilator-associated pneumonia – VAP), but can also occur through skin, especially though central venous lines (DOH, 2001c) and the gut. Exogenous infection is usually though contact (staff, procedures, equipment), but can also be airborne. Exogenous cross infection causes up to one-third of hospital acquired infections, at least half of which are preventable (Harbath et al., 2003).
