Sanvitti M, Kanapeckas L, Bilotta F. Minimizing hospital acquired intensive care unit infections: A focus on prevention. World J Crit Care Med 2026; 15(1): 113252 [DOI: 10.5492/wjccm.v15.i1.113252]
Corresponding Author of This Article
Federico Bilotta, MD, PhD, Professor, Department of Anesthesiology and Intensive Care, University of Tor Vergata, Via Cracovia 50, Rome 00133, Lazio, Italy. bilotta@tiscali.it
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Emergency Medicine
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Minireviews
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Mar 9, 2026 (publication date) through Mar 3, 2026
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World Journal of Critical Care Medicine
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2220-3141
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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
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Sanvitti M, Kanapeckas L, Bilotta F. Minimizing hospital acquired intensive care unit infections: A focus on prevention. World J Crit Care Med 2026; 15(1): 113252 [DOI: 10.5492/wjccm.v15.i1.113252]
World J Crit Care Med. Mar 9, 2026; 15(1): 113252 Published online Mar 9, 2026. doi: 10.5492/wjccm.v15.i1.113252
Minimizing hospital acquired intensive care unit infections: A focus on prevention
Marco Sanvitti, Laurynas Kanapeckas, Federico Bilotta
Marco Sanvitti, Department of Pediatric Surgery, "Sapienza" University of Rome, Rome 00185, Lazio, Italy
Laurynas Kanapeckas, Department of Neurosurgery, Lithuanian University of Health Sciences Kaunas Clinics, Kaunas 50161, Kauno Miestas, Lithuania
Federico Bilotta, Department of Anesthesiology and Intensive Care, University of Tor Vergata, Rome 00133, Lazio, Italy
Author contributions: Sanvitti M was the first author, responsible for conceptualizing and designing the review, conducting the literature search, analyzing and interpreting the data, and drafting the original manuscript; Kanapeckas L assisted with data extraction, literature review, and manuscript preparation; Bilotta F served as the senior author, supervising the project, providing critical revisions, and overseeing the overall direction of the work; all authors contributed to manuscript drafting and approved the submitted version.
Conflict-of-interest statement: There is no conflict of interest associated with any of the senior author or other coauthors contributed their efforts in this manuscript.
Corresponding author: Federico Bilotta, MD, PhD, Professor, Department of Anesthesiology and Intensive Care, University of Tor Vergata, Via Cracovia 50, Rome 00133, Lazio, Italy. bilotta@tiscali.it
Received: August 20, 2025 Revised: September 23, 2025 Accepted: December 3, 2025 Published online: March 9, 2026 Processing time: 192 Days and 17.5 Hours
Abstract
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.
Core Tip: Hospital-acquired infections remain frequent in intensive care units (ICUs), contributing to excess mortality, prolonged hospitalization, and higher costs. Evidence shows that adherence to hand hygiene, staff vaccination, and device-care bundles can substantially reduce ventilator-associated pneumonia, bloodstream, and urinary tract infections. Systemic measures such as adequate nurse-to-patient ratios, single-patient rooms, and closed ICU models further improve outcomes. This review integrates staff-level, patient-level, and organizational strategies, highlighting that effective prevention requires not only technical measures but consistent implementation, monitoring, and adaptation across different healthcare settings to achieve sustainable reductions in infection rates.
