Infection Prevention and Control
In the United States, estimates indicate that more than 750,000 people will present with severe sepsis, 51% of whom are likely to need ICU care and an additional 17% of whom will need ventilator support in another area such as intermediate care. Severe sepsis is one component on the spectrum of infectious diseases in which the critical care team must have ongoing expertise, including knowledge about the epidemiology of established and emerging infectious diseases, prevention of nosocomial infections, and the recognition and diagnosis of infections, as well as state-of-the-art treatment options. This section and the links to the right will assist the critical care provider by sharing the knowledge and experiences of experts in infectious disease topics in a variety of forms.
Catheter-Associated Urinary Tract Infections
According to the Centers of Disease Control and Prevention (CDC), urinary tract infections are the most common type of healthcare-associated infections (HAI), accounting for more than 30% of HAI reported by acute care hospitals across the United States. These infections occur due to poor catheter insertion, length of time in use and inappropriate patient selection. Catheter associated urinary tract infections (CAUTI) occur most frequently in women, the elderly and patients with impaired immunity, though any individual can contract a CAUTI in a hospital irrespective of their risk. The CDC offers updated (2009) guidelines, a podcast and a fast facts sheet on their HICPAC website (Hospital Infection Control Practices Advisory Committee) free to the public and clinicians. The guideline includes new research an technological advancements for the prevention of CAUTI for both short and long-term use of indwelling catheters. The guideline is designed to be used by administrators, nurses, physicians, other healthcare providers and persons responsible for developing, implementing and evaluating infection control programs for healthcare settings. Patients and families can read these guidelines to help them open a dialogue with their care providers.
Central Line-Associated Bloodstream Infections
According to the CDC, an estimated 248,000 bloodstream infections occur in U.S. hospitals each year with deaths estimated at upwards of 62,000 annually. It is believed a large portion of these incidents can be associated with the use of a central placed intravenous access line. There is a revised central line-associated bloodstream infection guideline in the final draft stages. It will be posted on this Web Page as soon as it becomes available. Materials to assist acute care facilities in surveillance and prevention are available on the CDC website. In 2008, the Agency for Healthcare Research and Quality awarded $3,000,000 via a three-year grant to assist hospitals in states across the country to improve. These and other resources are important efforts to assist clinicians in their efforts to protect patients from these hospital-acquired infections. Here are some additional resources:
Norovirus Gastroenteritis Outbreaks
Noroviruses are a group of viruses that cause gastroenteritis. Symptoms include nausea, vomiting, diarrhea and stomach cramping. The noroviruses can cause a low-grade fever, chills, headache, muscle aches, and fatigue. Symptoms usually last one or two days, but the viruses can spread from care provider to patient and patient to care provider. In patients already compromised in an ICU setting, prevention of the spread of this virus is key. Norovirus outbreaks as emerging infections have been on the rise in healthcare settings over the past several years. These infections can occur throughout acute care hospital settings. The CDC is developing a guideline projected to be published in 2010 to assist in the identification of environmental characteristics, methods to identify outbreaks and best practice to contain outbreaks. Critical care clinicians interested in working with their hospital infection control staff, can direct attention to the draft guideline available on the CDC website. While it is currently under comment period, the draft document can serve as an opportunity to learn more to help protect staff and patients in the acute care setting.
Ventilator Associated Pneumonia
For more information visit the Ventilator-Associated Pneumonia Learn ICU page.