healthcare-associated infection
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Etiology
- associated with a variety of causes, including
- use of medical devices, such as catheters & ventilators
- complications following a surgical procedure
- transmission between patients & healthcare workers
- antibiotic overuse
- major types of infection
- urinary tract infections (34-36%)
- catheter-associated urinary tract infections (75%)
- catheter-associated urinary tract infections increased 6% from 2009 to 2013[9]*
- surgical site infections (17-20%)
- bloodstream infections (11-14%)
- sepsis associated with intravascular catheters
- pneumonia (11-13%)
- infections associated with Clostridium difficile & MRSA
- 40% of elderly with bacteremia, 25% culture S aureus
- urinary tract infections (34-36%)
- risk factors include interruptions & working with colleagues[14]
* the only major type of infection to have increased from 2009 to 2013[9]
Epidemiology
- one of 10 leading causes of death in the US[3]
- more common in elderly
- nursing home care
- 50% of all major complications of hospitalization (nosocomial infection)
- home health
- hemodialysis
- wound management
- surgical-site infections & pneumonia most common[7]
- Clostridium difficile most common pathogen[7]
Laboratory
Management
- hand hygiene is the single most important measure to reduce risk of healthcare-associated infections[3]
- should be performed at a minimum before & after every patient contact[3]
- exercise standard precautions to prevent transmission of infection
- avoid unnecessary catheterizations
- leave catheters in place only as long as necessary
- only trained personnel should insert catheters
- use a cap, mask, sterile gown & gloves, & a large sterile drape for inserting central venous catheters
- do not remove hair prior to surgery unless it will interfere with the operation, then, use electric clippers
- preoperative antimicrobial prophylaxis
- body temperature control during surgery
- glycemic control in diabetics undergoing cardiac surgery
- drain & discard condensate that collects in mechanical ventilator tubing
- remove endotracheal tube as soon as possible
- elevate head of the bed to reduce risk of aspiration of gastric contents
- combination of quality improvement strategies may diminish healthcare-associated infection rates in hospitals[5]
- coordination of public health departments & hospitals can reduce healthcare-associated infections[10]
More general terms
More specific terms
Additional terms
References
- ↑ Crane SJ et al, Bloodstream infections in a geriatric cohort: A population- based study. Am J Med 2007, 120:1078 PMID: https://www.ncbi.nlm.nih.gov/pubmed/18060929
- ↑ HHS Action Plan to Prevent Healthcare-Associated Infections: Executive Summary http://www.hhs.gov/ophs/initiatives/hai/exsummary.html
- ↑ 3.0 3.1 3.2 3.3 Medical Knowledge Self Assessment Program (MKSAP) 15, 17, 18. American College of Physicians, Philadelphia 2009, 2015, 2018.
- ↑ 4.0 4.1 ARUP Consult: Health Care-Associated Infections - Nosocomial Infections deprecated reference
- ↑ 5.0 5.1 5.2 Hidron AI, Edwards JR, Patel J et al NHSN annual update: antimicrobial-resistant pathogens associated with healthcare-associated infections: annual summary of data reported to the National Healthcare Safety Network at the Centers for Disease Control and Prevention, 2006-2007. Infect Control Hosp Epidemiol. 2008 Nov;29(11):996-1011. PMID: https://www.ncbi.nlm.nih.gov/pubmed/18947320
- ↑ Horan TC, Andrus M, Dudeck MA. CDC/NHSN surveillance definition of health care-associated infection and criteria for specific types of infections in the acute care setting. Am J Infect Control. 2008 Jun;36(5):309-32. PMID: https://www.ncbi.nlm.nih.gov/pubmed/18538699
- ↑ 7.0 7.1 7.2 Magill SS et al Multistate Point-Prevalence Survey of Health Care-Associated Infections. N Engl J Med 2014; 370:1198-1208. March 27, 2014 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/24670166 <Internet> http://www.nejm.org/doi/full/10.1056/NEJMoa1306801
- ↑ Agency for Healthcare Research and Quality Prevention of Healthcare-Associated Infections. Closing the Quality Gap. Revisting the State of the Science. Excecutive Summary Evidence Report/Technology Assessment Number 208 http://www.effectivehealthcare.ahrq.gov/ehc/products/335/1335/EvidenceReport208_CQG-HAI_ExecutiveSummary_20121127.pdf
- ↑ 9.0 9.1 9.2 Centers for Disease Control and Prevention (CDC) National and State Healthcare Associated Infections. Progress Report. Jan 2015 http://www.cdc.gov/HAI/pdfs/progress-report/hai-progress-report.pdf
- ↑ 10.0 10.1 Slayton RB et al Vital Signs: Estimated Effects of a Coordinated Approach for Action to Reduce Antibiotic-Resistant Infections in Health Care Facilities - United States MMWR. August 4, 2015 / 64(Early Release);1-7 http://www.cdc.gov/mmwr/preview/mmwrhtml/mm64e0804a1.htm
- ↑ Yokoe DS, Anderson DJ, Berenholtz SM et al A compendium of strategies to prevent healthcare-associated infections in acute care hospitals: 2014 updates. Infect Control Hosp Epidemiol. 2014 Aug;35(8):967-77. PMID: https://www.ncbi.nlm.nih.gov/pubmed/25026611 Free PMC Article
- ↑ Sievert DM, Ricks P, Edwards JR et al Antimicrobial-resistant pathogens associated with healthcare- associated infections: summary of data reported to the National Healthcare Safety Network at the Centers for Disease Control and Prevention, 2009-2010. Infect Control Hosp Epidemiol. 2013 Jan;34(1):1-14. PMID: https://www.ncbi.nlm.nih.gov/pubmed/23221186
- ↑ 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
- ↑ 14.0 14.1 Arvidsson L, Lindberg M, Skytt B, Lindberg M. Healthcare personnel's working conditions in relation to risk behaviours for organism transmission: A mixed-methods study. J Clin Nurs. 2021 Jul 4. PMID: https://www.ncbi.nlm.nih.gov/pubmed/34219318
- ↑ Centers for Disease Control and Prevention (CDC) Healthcare-associated Infections (HAIs) http://www.cdc.gov/HAI/surveillance/index.html