Cross infection

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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. Clinical practice guidelines address the prevention of cross infections.[2]

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

Prevention

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

  • From the IHI 100,000 Lives Campaign[3][4]
    • "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.[5][6]
    • "Prevent Ventilator-AssociatedPneumonia…by implementing a series of interdependent, scientifically grounded steps including the 'Ventilator Bundle'."
  • From the IHI 5 Million Lives Campaign:[7][8] [9]
    • "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. [10] 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. [11]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. [12]

References

  1. ↑ Anonymous (2024), Cross infection (English). Medical Subject Headings. U.S. National Library of Medicine.
  2. ↑ Yokoe, Deborah S.; 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 (2008-10-01). "Executive Summary: A Compendium of Strategies to Prevent Healthcare-Associated Infections in Acute Care Hospitals". Infection Control and Hospital Epidemiology 29 (s1): S12-S21. DOI:10.1086/591060. Retrieved on 2008-10-10. Research Blogging.
  3. ↑ 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.
  4. ↑ Institute for Healthcare Improvement: Overview of the 100,000 Lives Campaign. Retrieved on 2008-01-03.
  5. ↑ “Status Quon’t”, IHI’s 2007 Progress Report (PDF file)
  6. ↑ "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.
  7. ↑ Institute for Healthcare Improvement: Campaign. Retrieved on 2008-01-03.
  8. ↑ "Overview of the 5 Million Lives Campaign"
  9. ↑ "IHI Launches National Initiative to Reduce Medical Harm in U.S. Hospitals, Builds on 100,000 Lives Campaign" Infection Control Today, December 12, 2006
  10. ↑ 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
  11. ↑ 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
  12. ↑ 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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