RT Book, Section
A1 Chandra, Subani
A1 Chong, David
A2 Oropello, John M.
A2 Pastores, Stephen M.
A2 Kvetan, Vladimir
SR Print(0)
ID 1136415477
T1 Health Care–Associated Infections
T2 Critical Care
YR 1
FD 1
PB McGraw-Hill Education
PP New York, NY
SN 9780071820813
LK accessanesthesiology.mhmedical.com/content.aspx?aid=1136415477
RD 2024/04/18
AB KEY  POINTSHealth  care–associated  infections  (HCAIs)  contribute  significantly  to  morbidity  and  mortality,  and  health  care  costs.The  most  frequent  HAIs  are  catheter-related  bloodstream  infections  (CRBSIs),  ventilator-associated  pneumonias  (VAPs),  infections  with  Clostridium  difficile,  surgical  site  infections  (SSIs),  and  catheter-associated  urinary  tract  infections  (CAUTIs).Major  preventive  strategies  to  reduce  CRBSIs  include  optimal  catheter  site  selection;  proper  hand  hygiene;  maximal  barrier  precautions  at  the  time  of  insertion;  chlorhexidine  skin  antisepsis,  use  of  chlorhexidine-impregnated  dressings,  or  use  of  antiseptic  or  antimicrobial-coated  catheters;  tunneled  insertion;  catheter  site  care  and  limited  manipulation  of  the  catheter;  and  daily  review  of  line  necessity  and  prompt  removal  of  unnecessary  lines.The  most  common  causes  for  VAPs  are  aerobic  gram-negative  bacilli  such  as  Pseudomonas  aeruginosa,  Klebsiella  pneumoniae,  and  Acinetobacter  species  and  less  commonly  gram-positive  organisms  such  as  Staphylococcus  aureus.C  difficile  can  cause  a  wide  range  of  disease  from  asymptomatic  infection  in  a  silent  carrier  state  to  fulminant  disease  associated  with  severe  sepsis  and  death.Essential  elements  of  the  SSI  bundle  include  appropriate  use  of  prophylactic  antibiotics;  appropriate  hair  removal,  controlled  postoperative  serum  glucose  in  patients  after  cardiac  surgery,  and  immediate  postoperative  normothermia  in  patients  with  colorectal  surgery.The  single  most  significant  risk  factor  for  a  CAUTI  is  the  prolonged  use  of  the  urinary  catheter.