infection control
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Management
Precautions to prevent spread of infection include:
- universal precautions
- standard precautions
- hand hygiene is the single most important measure for preventing healthcare-associated infections
- stethoscopes may also transmit pathogens
- disinfection of stethoscopes may be prudent[9]
- tuberculosis isolation
- strict isolation
Hospital environment:
- higher risk for acquiring MRSA in patients admitted to a hospital room where prior occupant was MRSA-positive (3.9% vs 2.9%)[2]
- higher risk of VRE in patients admitted to an ICU room where prior occupant was MRSA-positive (4.5% vs 2.8%)[2]
- > 90% of in-hospital acquisitions of MRSA & VRE occur in patients admitted to a hospital room where prior occupant was neither MRSA or VRE positive[2]
- MRSA decolonizing all ICU patients is superior to targeted decolonization or to screening & isolation[6]
- universal use of gowns & gloves in ICU may not reduce risk of infection with antibiotic-resistant organisms[7]
- use of non sterile glove after hand washing may reduce infection in pre-mature infants[11]
- nasal mupirocin for preventinb MRSA infections in ICU patients received daily baths with chlorhexidine[14]
Staffing:
- Nurse staffing levels, and especially job-related burnout, seem to be contributing factors in hospital infection rates[3]
- bare-below-the-elbows attire for inpatient settings
- if white coats are mandatory, more than one should be available, & hooks should be provided so that coats can be removed before patient contact
- all clothing that comes in contact with patients or patient environment should be washed after daily use; a hot water cycle, followed by a dryer cycle or ironing that can kill bacteria[8]
Waste disposal
- drug-resistant Escherichia coli are abundant in hospital waste water[10]
- the E coli survive waste water treatment
Emergence of antibiotic-resistant organisms
More general terms
More specific terms
Additional terms
- antimicrobial stewardship
- hand hygiene
- infection (infectious disease)
- nosocomial infection; nursing home acquired infection
- standard precautions
- universal precautions
References
- ↑ Medical Knowledge Self Assessment Program (MKSAP) 11, 16. American College of Physicians, Philadelphia 1998, 2012
- ↑ 2.0 2.1 2.2 2.3 Huang SS et al, Risk of acquiring antibiotic-resistant bacteria from prior room occupants. Arch Intern Med 2006, 166:1945 PMID: https://www.ncbi.nlm.nih.gov/pubmed/17030826
- ↑ 3.0 3.1 Cimiotti JP et al Nurse staffing, burnout, and health care - associated infection American Journal of Infection Control 40(6):486-490, August 2012 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/22854376 <Internet> http://www.ajicjournal.org/article/S0196-6553(12)00709-2/fulltext
- ↑ Burke JP. Infection control - a problem for patient safety. N Engl J Med. 2003 Feb 13;348(7):651-6. PMID: https://www.ncbi.nlm.nih.gov/pubmed/12584377
- ↑ Siegel JD, Rhinehart E, Jackson M et al 2007 Guideline for Isolation Precautions: Preventing Transmission of Infectious Agents in Health Care Settings. Am J Infect Control. 2007 Dec;35(10 Suppl 2):S65-164. PMID: https://www.ncbi.nlm.nih.gov/pubmed/18068815
- ↑ 6.0 6.1 Huang SS et al Targeted versus Universal Decolonization to Prevent ICU Infection. N Engl J Med 2013 Jun 13; 368:2255 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/23718152 <Internet> http://www.nejm.org/doi/full/10.1056/NEJMoa1207290
Edmond MB and Wenzel RP Screening Inpatients for MRSA - Case Closed N Engl J Med. May 29, 2013 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/23718155 <Internet> http://www.nejm.org/doi/full/10.1056/NEJMoa1207290 - ↑ 7.0 7.1 Harris AD et al Universal Glove and Gown Use and Acquisition of Antibiotic- Resistant Bacteria in the ICU. A Randomized Trial. JAMA. Published online October 04, 2013 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/24097234 <Internet> http://jama.jamanetwork.com/article.aspx?articleid=1746112
Malani PN Preventing Infections in the ICU. One Size Does Not Fit All. <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/24097192 <Internet> http://jama.jamanetwork.com/article.aspx?articleid=1746111 - ↑ 8.0 8.1 Bearman G et al Healthcare Personnel Attire in Non-Operating-Room Settings. Infection Control and Hospital Epidemiology 35(2) 2014 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/24442071 <Internet> http://www.jstor.org/stable/10.1086/675066
- ↑ 9.0 9.1 Longtin Y et al. Contamination of stethoscopes and physicians' hands after a physical examination. Mayo Clin Proc 2014 Mar; 89:291. PMID: https://www.ncbi.nlm.nih.gov/pubmed/24582188
Maki D. Stethoscopes and health care-associated infection. Mayo Clin Proc 2014 Mar; 89:277 PMID: https://www.ncbi.nlm.nih.gov/pubmed/24582185 - ↑ 10.0 10.1 Brechet C et al. Wastewater treatment plants release large amounts of extended-spectrum beta-lactamase-producing Escherichia coli into the environment. Clin Infect Dis 2014 Jun 15; 58:1658. <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/24795329 <Internet> http://cid.oxfordjournals.org/content/58/12/1658
Griffiths JK and Barza M. What happens in hospitals should stay in hospitals. Clin Infect Dis 2014 Jun 15; 58:1666 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/24795327 <Internet> http://cid.oxfordjournals.org/content/58/12/1666 - ↑ 11.0 11.1 Kaufman DA et al Nonsterile Glove Use in Addition to Hand Hygiene to Prevent Late-Onset Infection in Preterm InfantsRandomized Clinical Trial. JAMA Pediatr. Published online August 11, 2014 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/25111196 <Internet> http://archpedi.jamanetwork.com/article.aspx?articleid=1894732
Coffin SE Fighting Infections in the Neonatal Intensive Care Unit. Gloves On or Off? JAMA Pediatr. Published online August 11, 2014 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/25111036 <Internet> http://archpedi.jamanetwork.com/article.aspx?articleid=1894730 - ↑ Sydnor ER, Perl TM. Hospital epidemiology and infection control in acute-care settings. Clin Microbiol Rev. 2011 Jan;24(1):141-73. Review. PMID: https://www.ncbi.nlm.nih.gov/pubmed/21233510 Free PMC Article
- ↑ Banach DB, Johnston BL, Al-Zubeidi D et al Outbreak Response and Incident Management: SHEA Guidance and Resources for Healthcare Epidemiologists in United States Acute-Care Hospitals. Infection Control & Hospital Epidemiology. Published Dec 2017 https://www.cambridge.org/core/services/aop-cambridge-core/content/view/8C035426B3C86E075BBB0AFFAE42F0AC/S0899823X17002124a.pdf/outbreak_response_and_incident_management_shea_guidance_and_resources_for_healthcare_epidemiologists_in_united_states_acutecare_hospitals.pdf
- ↑ 14.0 14.1 Huang SS, Septimus EJ, Kleinman K et al Nasal Iodophor Antiseptic vs Nasal Mupirocin Antibiotic in the Setting of Chlorhexidine Bathing to Prevent Infections in Adult ICUs. A Randomized Clinical Trial. JAMA. 2023;330(14):1337-1347 PMID: https://www.ncbi.nlm.nih.gov/pubmed/37815567 https://jamanetwork.com/journals/jama/fullarticle/2810510
- ↑ Centers for Disease Control & Prevention (CDC) Executive Summary: Infection Control in Healthcare Personnel: Infrastructure and Routine Practices for Occupational Infection Prevention and Control Services (2019) https://www.cdc.gov/infectioncontrol/guidelines/healthcare-personnel/exec-summary.html
- ↑ Centers for Disease Control and Prevention (CDC) Guide to Infection Prevention for Outpatient Settings: Minimum Expectations for Safe Care. http://www.cdc.gov/hai/settings/outpatient/outpatient-care-guidelines.html