ABSTRACT
The problem of antimicrobial resistance has increased significantly in the past decade and
is now a major issue in most hospitals. A number of factors magnify this problem in the
intensive care unit (ICU). These factors include the multiple invasive devices and pro-
cedures predisposing the ICU patient to infection, the widespread use of broad-spectrum
antibiotics, lapse of infection control technique in the care of critically ill patients,
and economic pressures that lead to understaffing. Antimicrobial resistance is a greater
urgency for those multidrug-resistant organisms for which only a few antibiotic alterna-
tives remain, such as vancomycin-resistant Enterococci and carbapenem-resistant
Acinetobacter baumannii. Multiple drug resistance also increases health care costs, adds
isolation precautions to the care of an already complicated patient, and results in
inadequate empiric therapy that increases mortality. Understanding the current problems
of antibiotic resistance will enhance the care and management of individual patients with
these organisms in the ICU and lead to better prevention and control measures to decrease
the prevalence of this problem.
