Unsurprisingly, this topic appears frequently in the exam. For instance, a broad approach to the topic was interrogated in Question 10 from the first paper of 2002: "Outline the aetiology, clinical manifestations and possible preventative measures for nosocomial infections in Intensive Care."
An ideal reference for the time-rich candidate would be Oh's Manual: Chapter 70 (pp. 724), "Nosocomial infections" by James Hatcher and Rishi H-P Dhillon. The time-poor reader would probably find their last minute panic better served by this excellent LITFL summary article.
A good article reporting on the epidemiology of nosocomial infection in American ICUs is also available, as well as a detailed paper on preventative measures.
Taken together, these references have been boiled down into a point-form list.
The following risk factors for nosocomial infections have been identified:
So common are they, tat virtually all of them have at some stage merited a whole CICM fellowship question dedicated to them. Links to relevant sections are offered below.
For the bureaucrat within, prevalence statistics and data collection methodology are an opportunity for gentle statistical massage, or just some good old-fashioned bullshit. For instance, it is possible to decrease the apparent rate of VAP by a number of grossly Machiavellian methods. These strategies would be an excellent answer to a hypothetical CICM question:
You are the director of a Level 3 ICU. Hospital governance has pointed out that your unit has a high prevalence of VAP, and asked that you address this issue. However, you have neither the interest nor the time.
Describe your approach to rapidly covering up the true prevalence of VAP in your unit.
Chapter 70 (pp. 724) Nosocomial infections by James Hatcher and Rishi H-P Dhillon
Ak, Oznur, et al. "Nosocomial infections and risk factors in the intensive care unit of a teaching and research hospital: A prospecive cohort study." Medical Science Monitor 17.5 (2011): PH29-PH34.
Barnett, Adrian G., et al. "The increased risks of death and extra lengths of hospital and ICU stay from hospital-acquired bloodstream infections: a case–control study." BMJ open 3.10 (2013): e003587.
Doyle, Joseph S., et al. "Epidemiology of infections acquired in intensive care units." Seminars in respiratory and critical care medicine. Vol. 32. No. 02. © Thieme Medical Publishers, 2011.
ANZIC statement on central line insertion
Richards, Michael J., et al. "Nosocomial infections in combined medical-surgical intensive care units in the United States." Infection control and hospital epidemiology 21.8 (2000): 510-515.
Lepape, A. "Prevention of nosocomial infections in ICU. What is really effective?." Medicinski arhiv 57.4 Suppl 1 (2002): 15-18.
Klompas, Michael. "Eight initiatives that misleadingly lower ventilator-associated pneumonia rates." American journal of infection control 40.5 (2012): 408-410.