Health-care-associated infections

Table 74—2 presents the recommended agents for treatment of community-acquired and complicated intraabdominal infections from the Infectious Diseases Society of America and the Surgical Infection Society.21-23 These recommendations were formulated using an evidence-based approach. Most community-acquired infections are mild to moderate, whereas health care-associated infections tend to be more severe and difficult to treat. Table 74-3 presents guidelines for treatment and alternative regimens for specific situations. These are general guidelines there are many factors that cannot be incorporated into such a table. 

Klevens, R.M., Edwards, J.R., and Gaynes, R.P. (2008). The impact of antimicrobial-resistant, health care-associated infections on mortality in the United States. Clin Infect Dis 47 927-930. 

Klevens RM, Edwards JR, Richards CL, Horan TC, Gaynes RP, Pollock DA, et al. Estimating health care-associated infections and deaths in US hospitals, 2002. Public Health Rep2007 122 160. 

It is now widely accepted that nuCTobial biofihns play a key role in all types of health-care-associated infections and especially in those related to medical devices. Particularly, biofilm formation on the device surfaces contributes to the severity of these infections. Indeed the development of biofilm is responsible for the chronic nature of related infections, and for the inherent resistance to antibiotic therapy. Raad et al. were among the first investigators who isolated biofilm-producing microorganisms from the intraluminal surface of CVCs, which r ained in situ for more than 30 days. 

The Health Care Associated Infections (HCAI) represent a serious problem and a major challenge, requiring effective preventive measures and control for health services (National Health Surveillance Agency, 2009). 

Taking into account the results obtained and depending on the number of correct responses, it was verified that the questions Which of the following statements about the technique of hand hygiene with alcohol solution are true , Mark with a X where do you think you should use Technique Handwashing with soap and water and Friction with antiseptic handrub and Health Care Associated Infections (HCAI) affect showed the highest number of positive responses (n > 11). 

Health care-associated infections (HAIs) are one of the major threats to patient safety, yet they have not been widely perceived as such before the advent of the patient safety movement. Between one and two third of HAIs are thought to be preventable [ 1 ], which would translate into ten thousands of saved lives and billions of dollars in expenses avoided in US hospitals alone each year. A number of entities such as the Centers for Disease Control and Prevention (CDC), the Society for Healthcare Epidemiology of America (SHEA), the European Renal Association (ERA), and also the patient safety-oriented Institute for Healthcare Improvement (www.ihi.org) therefore publish HAl prevention guidelines to advance implementation of best practices [2, 3]. The incidence of central line-associated bloodstream infections (CLABSIs), which exhibit higher mortality than most other HAIs, may drop to rates as low as zero with a robust infection prevention program [4]. 

Barrier precautions to prevent health care-associated infections Use of real-time ultrasonography for central line placement... 

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