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Chapter 8 : Prevention of Health Care-Associated Infections

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Abstract:

Health care-associated infections (HAIs) are among the most common complications of health care delivery. Every health care facility must have an infection prevention program charged with monitoring and preventing infections in the health care environment. The clinical microbiology laboratory is inextricably linked to any infection prevention program, because preventing infections requires the ability to diagnose those infections when they occur. In this chapter, we discuss the impact of HAIs, outline the organization of the hospital infection prevention program, and describe the important roles of the clinical microbiology laboratory in HAI prevention. These roles include essential support for surveillance, outbreak detection and management, antimicrobial stewardship, risk assessment and planning, and education. In summary, the clinical microbiology laboratory is an essential element of any effective infection prevention program.

Citation: Diekema D, Pfaller M. 2015. Prevention of Health Care-Associated Infections, p 106-119. In Jorgensen J, Pfaller M, Carroll K, Funke G, Landry M, Richter S, Warnock D (ed), Manual of Clinical Microbiology, Eleventh Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817381.ch8
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Rates of central venous catheter (CVC)-associated infection in a medical ICU (MICU). Sample chart format for reporting nosocomial infection rates in an ICU compared with CDC NHSN benchmarks. doi:1128/9781555817381.ch8.f1

Citation: Diekema D, Pfaller M. 2015. Prevention of Health Care-Associated Infections, p 106-119. In Jorgensen J, Pfaller M, Carroll K, Funke G, Landry M, Richter S, Warnock D (ed), Manual of Clinical Microbiology, Eleventh Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817381.ch8
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Tables

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TABLE 1

Commonly used terms in health care epidemiology

Citation: Diekema D, Pfaller M. 2015. Prevention of Health Care-Associated Infections, p 106-119. In Jorgensen J, Pfaller M, Carroll K, Funke G, Landry M, Richter S, Warnock D (ed), Manual of Clinical Microbiology, Eleventh Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817381.ch8
Generic image for table
TABLE 2

Distribution of the five most common nosocomial pathogens isolated from major infection sites reported to the NHSN from 2009 to 2010

Citation: Diekema D, Pfaller M. 2015. Prevention of Health Care-Associated Infections, p 106-119. In Jorgensen J, Pfaller M, Carroll K, Funke G, Landry M, Richter S, Warnock D (ed), Manual of Clinical Microbiology, Eleventh Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817381.ch8
Generic image for table
TABLE 3

Attributable mortality of nosocomial bloodstream infection due to selected pathogens

Citation: Diekema D, Pfaller M. 2015. Prevention of Health Care-Associated Infections, p 106-119. In Jorgensen J, Pfaller M, Carroll K, Funke G, Landry M, Richter S, Warnock D (ed), Manual of Clinical Microbiology, Eleventh Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817381.ch8
Generic image for table
TABLE 4

Steps in nosocomial outbreak investigation and the role of the laboratory at each step

Citation: Diekema D, Pfaller M. 2015. Prevention of Health Care-Associated Infections, p 106-119. In Jorgensen J, Pfaller M, Carroll K, Funke G, Landry M, Richter S, Warnock D (ed), Manual of Clinical Microbiology, Eleventh Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817381.ch8
Generic image for table
TABLE 5

Screening patients and health care workers for asymptomatic carriage of organisms of epidemiologic significance

Citation: Diekema D, Pfaller M. 2015. Prevention of Health Care-Associated Infections, p 106-119. In Jorgensen J, Pfaller M, Carroll K, Funke G, Landry M, Richter S, Warnock D (ed), Manual of Clinical Microbiology, Eleventh Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817381.ch8
Generic image for table
TABLE 6

Screening environmental sources (air, water, and surfaces) for organisms of epidemiologic significance

Citation: Diekema D, Pfaller M. 2015. Prevention of Health Care-Associated Infections, p 106-119. In Jorgensen J, Pfaller M, Carroll K, Funke G, Landry M, Richter S, Warnock D (ed), Manual of Clinical Microbiology, Eleventh Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817381.ch8

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