Healthcare Associated Infection

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Contents 1 More Specific Terms 2 Etiology 3 Epidemiology 4 Management 5 More General Terms 6 Additional Terms 7 References

More Specific Terms

• nosocomial infection

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%)

• surgical site infections (17-20%)
• bloodstream infections (11-14%)

• sepsis associated with intravascular catheters

• pneumonia (11-13%)

• ventilator-associated pneumonia

• infections associated with Clostridium difficile & MRSA
• 40% of elderly with bacteremia, 25% culture S aureus

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

Management

• hand hygeine is the single most important measure to reduce risk of healthcare-associated infections [3]
• 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

More General Terms

• infection (infectious disease)
• iatrogenic disease

Additional Terms

• risk factors for hospital-acquired pneumonia

References

1. Crane SJ et al, Bloodstream infections in a geriatric cohort: A population- based study. Am J Med 2007, 120:1078 PMID: [1]
2. HHS Action Plan to Prevent Healthcare-Associated Infections: Executive Summary [2]
3. Medical Knowledge Self Assessment Program (MKSAP) 15, American College of Physicians, Philadelphia 2009

healthcare-associated infection