Cross infection: Difference between revisions

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imported>Howard C. Berkowitz
(Added general CDC as well as MRSA)
imported>Robert Badgett
(Moved some content to new 'Infection control' article)
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In health care, a '''cross infection''', also called a '''hospital infection''' or a '''nosocomial infection''', is "any infection which a patient contracts in a health-care institution."<ref>{{MeSH}}</ref> Important microbes are methicillin-resistant ''[[Staphylococcus aureus]]'' (MRSA), ''[[Pseudomonas aeruginosa]]'' and ''[[Clostridium difficile]].'' [[Clinical practice guideline]]s address the prevention of cross infections.<ref>{{Cite journal | doi = 10.1086/591060 | volume = 29 | issue = s1 | pages = S12-S21 | last = Yokoe
In health care, a '''cross infection''', also called a '''hospital infection''' or a '''nosocomial infection''', is "any infection which a patient contracts in a health-care institution."<ref>{{MeSH}}</ref> Important microbes are methicillin-resistant ''[[Staphylococcus aureus]]'' (MRSA), ''[[Pseudomonas aeruginosa]]'' and ''[[Clostridium difficile]].''
| first = Deborah S. | coauthors = Leonard A. Mermel, Deverick J. Anderson, Kathleen M. Arias, Helen Burstin, David P. Calfee, Susan E. Coffin, Erik R. Dubberke, Victoria Fraser, Dale N. Gerding, Frances A. Griffin, Peter Gross, Keith S. Kaye, Michael Klompas, Evelyn Lo, Jonas Marschall, Lindsay Nicolle, David A. Pegues, Trish M. Perl, Kelly Podgorny, Sanjay Saint, Cassandra D. Salgado, Robert A. Weinstein, Robert Wise, David Classen
| title = Executive Summary: A Compendium of Strategies to Prevent Healthcare-Associated Infections in Acute Care Hospitals  | journal = Infection Control and Hospital Epidemiology
| accessdate = 2008-10-10 | date = 2008-10-01 | url = http://www.journals.uchicago.edu/doi/abs/10.1086/591060 }}</ref>


Examples include [[ventilator-associated pneumonia]], [[surgical wound infection|surgical site infections]], and infections of [[indwelling catheter]]s, such as [[central venous catheter]]s and [[urinary catheter]]s.
Examples include [[ventilator-associated pneumonia]], [[surgical wound infection|surgical site infections]], and infections of [[indwelling catheter]]s, such as [[central venous catheter]]s and [[urinary catheter]]s.


==Prevention==
==Prevention==
{{main|Infection control}}
Prevention of cross infections is a priority of the [http://www.ihi.org Institute for Healthcare Improvement] (IHI).  
Prevention of cross infections is a priority of the [http://www.ihi.org Institute for Healthcare Improvement] (IHI).  
* From the IHI 100,000 Lives Campaign<ref name="pmid16418469">{{cite journal |author=Berwick DM, Calkins DR, McCannon CJ, Hackbarth AD |title=The 100,000 lives campaign: setting a goal and a deadline for improving health care quality |journal=JAMA |volume=295 |issue=3 |pages=324–7 |year=2006 |pmid=16418469 |doi=10.1001/jama.295.3.324}}</ref><ref name="titleInstitute for Healthcare Improvement: Overview of the 100,000 Lives Campaign">{{cite web |url=http://www.ihi.org/IHI/Programs/Campaign/100kCampaignOverviewArchive.htm |title=Institute for Healthcare Improvement: Overview of the 100,000 Lives Campaign |accessdate=2008-01-03 |author= |authorlink= |coauthors= |date= |format= |work= |publisher= |pages= |language= |archiveurl= |archivedate= |quote=}}</ref>
* From the IHI 100,000 Lives Campaign<ref name="pmid16418469">{{cite journal |author=Berwick DM, Calkins DR, McCannon CJ, Hackbarth AD |title=The 100,000 lives campaign: setting a goal and a deadline for improving health care quality |journal=JAMA |volume=295 |issue=3 |pages=324–7 |year=2006 |pmid=16418469 |doi=10.1001/jama.295.3.324}}</ref><ref name="titleInstitute for Healthcare Improvement: Overview of the 100,000 Lives Campaign">{{cite web |url=http://www.ihi.org/IHI/Programs/Campaign/100kCampaignOverviewArchive.htm |title=Institute for Healthcare Improvement: Overview of the 100,000 Lives Campaign |accessdate=2008-01-03 |author= |authorlink= |coauthors= |date= |format= |work= |publisher= |pages= |language= |archiveurl= |archivedate= |quote=}}</ref>
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**"Reduce Methicillin-Resistant [[Staphylococcus aureus]] (MRSA) infection…by reliably implementing scientifically proven infection control practices."
**"Reduce Methicillin-Resistant [[Staphylococcus aureus]] (MRSA) infection…by reliably implementing scientifically proven infection control practices."


Some sources may be obscure ''[[Legionella]]'' spp., known to colonize building heating, ventilation and air conditioning (HVAC) systems, has caused infection from hospital equipment that traditionally has been considered resistant to bacterial growth, such as heated bedside humidifiers. <ref>{{citation
Some sources may be obscure ''[[Legionella]]'' spp., known to colonize building heating, ventilation and air conditioning (HVAC) systems, has caused infection from hospital equipment that traditionally has been considered resistant to bacterial growth, such as heated bedside humidifiers. <ref>{{citation |journal = Morbidity and Mortality Weekly Report |date = March 26, 2004 | volume = 53(RR03) | pages = 1-36 |title = Guidelines for Preventing Health-Care--Associated Pneumonia, 2003
|journal = Morbidity and Mortality Weekly Report
|author = Recommendations of CDC and the Healthcare Infection Control Practices Advisory Committee }}</ref> The replacement of heated with ultrasonic humidifiers reduced a risk of burns but increased the risk of infection; current practices include sterilizing humidifiers between patients, changing water frequently, and using sterile water.
|date = March 26, 2004  
 
| volume = 53(RR03)
| pages = 1-36
|title = Guidelines for Preventing Health-Care--Associated Pneumonia, 2003
|author = Recommendations of CDC and the Healthcare Infection Control Practices Advisory Committee
}}</ref> The replacement of heated with ultrasonic humidifiers reduced a risk of burns but increased the risk of infection; current practices include sterilizing humidifiers between patients, changing water frequently, and using sterile water.
==Surveillance==
==Surveillance==
==Characteristics of nosocomial infections==
==Characteristics of nosocomial infections==
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  | url = http://www.cdc.gov/ncidod/dhqp/pdf/ar/mdroGuideline2006.pdf}}</ref>Given the ability for [[antibiotic resistance]] to transfer among organisms, less common antibiotics may be needed to treat multidrug-resistant forms.  
  | url = http://www.cdc.gov/ncidod/dhqp/pdf/ar/mdroGuideline2006.pdf}}</ref>Given the ability for [[antibiotic resistance]] to transfer among organisms, less common antibiotics may be needed to treat multidrug-resistant forms.  


Unfortunately, some of these antibiotics may introduce new problems; one such drug recommended for MRSA, [[clindamycin]], is associated with inducing ''Cl. difficile'' superinfection. <ref name=Gorwitz>{{citation
Unfortunately, some of these antibiotics may introduce new problems; one such drug recommended for MRSA, [[clindamycin]], is associated with inducing ''Cl. difficile'' superinfection. <ref name=Gorwitz>{{citation  | author = Gorwitz RJ, Jernigan DB, Powers JH, Jernigan JA, and Participants in the CDC Convened Experts’ Meeting on Management of MRSA in the Community  | id = Gorwitz  | title = Strategies for clinical management of MRSA in the community: Summary of an experts’ meeting convened by the Centers for Disease Control and Prevention  | year = 2006  | url = http://www.cdc.gov/ncidod/dhqp/ar_mrsa_ca.html}}</ref>
  | author = Gorwitz RJ, Jernigan DB, Powers JH, Jernigan JA, and Participants in the CDC Convened
Experts’ Meeting on Management of MRSA in the Community
  | id = Gorwitz
  | title = Strategies for clinical management of MRSA in the community: Summary of an experts’ meeting convened by the Centers for Disease Control and Prevention
  | year = 2006
  | url = http://www.cdc.gov/ncidod/dhqp/ar_mrsa_ca.html}}</ref>


==References==
==References==
<references/>
<references/>

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In health care, a cross infection, also called a hospital infection or a nosocomial infection, is "any infection which a patient contracts in a health-care institution."[1] Important microbes are methicillin-resistant Staphylococcus aureus (MRSA), Pseudomonas aeruginosa and Clostridium difficile.

Examples include ventilator-associated pneumonia, surgical site infections, and infections of indwelling catheters, such as central venous catheters and urinary catheters.

Prevention

For more information, see: Infection control.

Prevention of cross infections is a priority of the Institute for Healthcare Improvement (IHI).

  • From the IHI 100,000 Lives Campaign[2][3]
    • "Prevent Central Line Infections…by implementing a series of interdependent, scientifically grounded steps called the "Central Line Bundle"."
    • "Prevent Surgical Site Infections…by reliably delivering the correct perioperative antibiotics at the proper time." Significant reduction may be achieved by procedures as simple as proper hand washing, use of clippers rather than razors to shave the site of surgery, or prompt administration of antibiotics following surgery.[4][5]
    • "Prevent Ventilator-AssociatedPneumonia…by implementing a series of interdependent, scientifically grounded steps including the 'Ventilator Bundle'."
  • From the IHI 5 Million Lives Campaign:[6][7] [8]
    • "Reduce Methicillin-Resistant Staphylococcus aureus (MRSA) infection…by reliably implementing scientifically proven infection control practices."

Some sources may be obscure Legionella spp., known to colonize building heating, ventilation and air conditioning (HVAC) systems, has caused infection from hospital equipment that traditionally has been considered resistant to bacterial growth, such as heated bedside humidifiers. [9] The replacement of heated with ultrasonic humidifiers reduced a risk of burns but increased the risk of infection; current practices include sterilizing humidifiers between patients, changing water frequently, and using sterile water.

Surveillance

Characteristics of nosocomial infections

Nosocomially-acquired infection often are resistant to multiple antibiotics. [10]Given the ability for antibiotic resistance to transfer among organisms, less common antibiotics may be needed to treat multidrug-resistant forms.

Unfortunately, some of these antibiotics may introduce new problems; one such drug recommended for MRSA, clindamycin, is associated with inducing Cl. difficile superinfection. [11]

References

  1. ↑ Anonymous (2024), Cross infection (English). Medical Subject Headings. U.S. National Library of Medicine.
  2. ↑ Berwick DM, Calkins DR, McCannon CJ, Hackbarth AD (2006). "The 100,000 lives campaign: setting a goal and a deadline for improving health care quality". JAMA 295 (3): 324–7. DOI:10.1001/jama.295.3.324. PMID 16418469. Research Blogging.
  3. ↑ Institute for Healthcare Improvement: Overview of the 100,000 Lives Campaign. Retrieved on 2008-01-03.
  4. ↑ “Status Quon’t”, IHI’s 2007 Progress Report (PDF file)
  5. ↑ "Nosocomial Infection: Approach to Postoperative Symptoms of Infection", From ACS Surgery Online, Posted 06/07/2006, E. Patchen Dellinger, M.D., F.A.C.S.
  6. ↑ Institute for Healthcare Improvement: Campaign. Retrieved on 2008-01-03.
  7. ↑ "Overview of the 5 Million Lives Campaign"
  8. ↑ "IHI Launches National Initiative to Reduce Medical Harm in U.S. Hospitals, Builds on 100,000 Lives Campaign" Infection Control Today, December 12, 2006
  9. ↑ Recommendations of CDC and the Healthcare Infection Control Practices Advisory Committee (March 26, 2004), "Guidelines for Preventing Health-Care--Associated Pneumonia, 2003", Morbidity and Mortality Weekly Report 53(RR03): 1-36
  10. ↑ Jane D. Siegel, Emily Rhinehart, Marguerite Jackson, Linda Chiarello, the Healthcare Infection Control Practices Advisory Committee (2006), Management of Multidrug-Resistant Organisms In Healthcare Settings,, Centers for Disease Control
  11. ↑ Gorwitz RJ, Jernigan DB, Powers JH, Jernigan JA, and Participants in the CDC Convened Experts’ Meeting on Management of MRSA in the Community (2006), Strategies for clinical management of MRSA in the community: Summary of an experts’ meeting convened by the Centers for Disease Control and Prevention, Gorwitz
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