By the bioMérieux Connection Editors
Healthcare-associated infections (HAIs) are infections that are acquired while receiving healthcare for another condition. HAIs can be transmitted in any healthcare environment, including hospitals, surgical centers, and long-term care facilities like nursing homes. It is estimated that one out of every twenty hospitalized patients will contract an HAI. These infections are a significant cause of illness and mortality, and are the source of serious economic consequences for the US health system each year.
The unfortunate truth is that hospitals have inherent qualities that facilitate the spread of HAIs, making it possible for a patient to get a completely different infection while obtaining care for their existing condition. Patients with compromised immune systems, continuous direct contact between patients and medical staff, and the use of medical devices all contribute to the risk of a patient developing an HAI.
Basic Infection Prevention Best Practices
The CDC recommends two tiers of precautions to prevent the spread of infections in healthcare settings: standard precautions and transmission-based precautions.
Standard precautions make use of common-sense practices and personal protective equipment (PPE) to defend both patients and healthcare providers from infection. These methods include:
- Proper hand hygiene
- Use of PPE when there is risk of exposure to infection
- Following appropriate cough etiquette principles
- Ensuring suitable patient placement within the facility and in relation to other patients
- Properly handling, cleaning and disinfecting equipment, instruments, and surfaces
- Handling laundry carefully
- Following safe injection practices
- Ensuring safety when handling needles and other sharp objects
However, “With COVID-19 ramping up in the United States, the supply chain’s ability to maintain PPE availability is being tested,” says John Hurst, PharmD, BCIDP, Senior Director of Antimicrobial Stewardship at bioMérieux. “First responders and frontline clinicians face difficult choices as they encounter PPE shortages and will need to adapt to changing guidance from the CDC, hospital infection prevention leadership, local health departments, and their respective professional organizations regarding first responder, health care provider, and patient safety.”
The components of standard precautions not requiring PPE will remain essential to infection prevention.
Transmission-based precautions are the second tier of basic infection prevention control and are meant to be used with patients who are already infected or colonized with an infection, in addition to the standard precautions mentioned above. This second tier includes prevention methods related to infections spread through direct contact, infections dispersed through droplets (sneezing, coughing, and talking), and infections transmitted by the airborne route (e.g., tuberculosis, measles, and chickenpox).
The CDC provides resources and tools designed to help healthcare providers implement Standard and Transmission-Based Precautions and prevent infections.
Infection Prevention and Antimicrobial Resistant Infections
Lack of appropriate infection control practices can enable antimicrobial resistance. Many HAIs are caused by bacteria that are serious antibiotic-resistant threats. As such, infection preventionists and health care epidemiologists are critical team members in any effective Antimicrobial Stewardship Program. On top of incorporating these infection control experts into stewardship efforts, more thorough prevention practices must be undertaken when handling a patient with a resistant infection.
For example, the CDC outlines specific infection prevention guidelines for working with patients infected with C. auris. C. auris infections are becoming increasingly common, and they are more frequently resistant to antifungal drugs doctors typically use to treat them. Rather than soap and water, alcohol-based hand sanitizer is the preferred hand hygiene method for this type of infection. C. auris patients should be placed in single rooms if possible, and daily cleaning and disinfection of these patients’ rooms should be undertaken. C. auris can persist on surfaces such as bed rails and tables, and even surfaces farther away from a patient such as windowsills. It can also travel via mobile equipment that can be shared between patients, including ultrasound machines, blood pressure cuffs, and other items. Any surface or item that comes into contact with an infected patient should be disinfected according to manufacturer instructions. In addition to these sanitation guidelines, the CDC offers numerous recommendations regarding patient transport, screening, and surveillance.
Infection prevention becomes even more important when dealing with resistant infections, but basic prevention best practices are always critical to ensure patient safety. Proper infection prevention and surveillance is and should continue to be a top priority for health care providers.
Opinions expressed in this article are not necessarily those of bioMérieux, Inc.