Minimizing hospital acquired intensive care unit infections: A focus on prevention

Hospital-acquired infections (HAIs) are a leading cause of morbidity and mortality in intensive care units (ICUs), largely driven by invasive devices, immunosuppression, and prolonged hospitalization. Despite available guidelines, prevention strategies remain inconsistently applied across settings. This narrative review synthesized evidence from PubMed (2020-2025) and key guideline documents (World Health Organization, Centers for Disease Control and Prevention, Infectious Diseases Society of America, Society for Healthcare Epidemiology of America), focusing on staff-level, patient-level, and systemic interventions for ICU infection prevention. Eligible sources included systematic reviews, clinical trials, consensus statements, and implementation studies. Effective staff-level strategies include strict hand hygiene, correct use of personal protective equipment, vaccination, and decontamination of personal devices, supported by audits and feedback. Patient-level care bundles targeting ventilator-associated pneumonia, central line-associated bloodstream infection, and catheter-associated urinary tract infection reduce device-related complications, though real-world adherence varies. Systemic measures such as closed ICU models, adequate nurse-to-patient ratios, triage protocols, and single-patient rooms, further mitigate infection risks. Implementation barriers include resource limitations, compliance gaps, and ethical considerations regarding futile care. Preventing ICU-acquired infections requires coordinated, multifaceted strategies embedded into daily practice. Sustained progress depends on leadership, continuous education, auditing, and adaptation of international frameworks to local contexts.