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Disinfection and Sterilization in Health Care Facilities
All invasive procedures involve contact by a medical device or surgical instrument with a patient ’s sterile tissue or mucous membranes. The level of disinfection is dependent on the intended use of the object: critical, semicritical, or noncritical. New issues and practices can affect the risk of infection associated with devices and surfaces. Endoscopes continue to represent a nosocomial haz ard. The contaminated surface environment in hospital rooms is important in the transmission of health care–associated pathogens. Thoroughness of cleaning must be monitored and no-touch room decontamination technology should be. ...
Source: Infectious Diseases Clinics of North America - August 4, 2021 Category: Infectious Diseases Authors: William A. Rutala, David J. Weber Source Type: research

Health Care Environmental Hygiene
Recent research has significantly clarified the impact of optimizing patient-zone environmental hygiene. New insights into the environmental microbial epidemiology of many hospital-associated pathogens, especially Clostridioides difficile, have clarified and quantified the role of ongoing occult pathogen transmission from the near-patient environment. The recent development of safe, broadly effective surface chemical disinfectants has led to new opportunities to broadly enhance environmental hygiene in all health care settings. The Centers for Disease Control and Prevention has recently developed a detailed guidance to ass...
Source: Infectious Diseases Clinics of North America - August 4, 2021 Category: Infectious Diseases Authors: Philip C. Carling Source Type: research

Outbreaks in Health Care Settings
Outbreaks and pseudo-outbreaks in health care settings are complex and should be evaluated systematically using epidemiologic and molecular tools. Outbreaks result from failures of infection prevention practices, inadequate staffing, and undertrained or overcommitted health care personnel. Contaminated hands, equipment, supplies, water, ventilation systems, and environment may also contribute. Neonatal intensive care, endoscopy, oncology, and transplant units are areas at particular risk. Procedures, such as bronchoscopy and endoscopy, are sources of infection when cleaning and disinfection processes are inadequate. New ty...
Source: Infectious Diseases Clinics of North America - August 4, 2021 Category: Infectious Diseases Authors: Geeta Sood, Trish M. Perl Source Type: research

Water Safety and Health Care
Health care facility water systems have been associated with the transmission of opportunistic premise plumbing pathogens such as Legionella and nontuberculous mycobacteria. These pathogens can enter a building ’s water system in low numbers and then proliferate when conditions are conducive to their growth. Patients and residents in health care facilities are often at heightened risk for opportunistic infections, and cases and outbreaks in the literature highlight the importance of routine water managem ent programs and occasions for intervention to prevent additional cases. A multidisciplinary proactive approach to wat...
Source: Infectious Diseases Clinics of North America - August 4, 2021 Category: Infectious Diseases Authors: Shantini D. Gamage, Meredith Ambrose, Stephen M. Kralovic, Gary A. Roselle Source Type: research

Occupational Health Update
An effective occupational health program is a key aspect of preventing exposure to infectious agents and subsequent infection, as well as evaluation and management of postexposure prophylaxis and infections in health care personnel (HCP) by educating HCP regarding proper handling of sharps, early identification and isolation of potentially infectious patients, implementation of standard and transmission-based precautions, and offering counseling of HCP regarding nonroutine prophylaxis. Occupational health services (OHS) must also apply standardized processes for determining when exposures have occurred and providing approp...
Source: Infectious Diseases Clinics of North America - August 4, 2021 Category: Infectious Diseases Authors: Erica S. Shenoy, David J. Weber Source Type: research

Occupational Health Update
Health care personnel (HCP) are at risk of exposure to infectious agents depending on their job duties and other factors. Risks include percutaneous exposure to blood-borne pathogens via sharp injuries (eg, human immunodeficiency virus, hepatitis B virus, hepatitis C virus); exposure by direct contact, droplet, or airborne transmission of pathogens through direct patient care (eg, pertussis, invasive meningococcus infections, tuberculosis); and through indirect contact transmission related to the contaminated health care environment (eg, Clostridioides difficile). Occupational health programs must effectively identify and ...
Source: Infectious Diseases Clinics of North America - August 4, 2021 Category: Infectious Diseases Authors: Erica S. Shenoy, David J. Weber Source Type: research

Computer Informatics for Infection Control
This article reviews the use of informatics for infection control. (Source: Infectious Diseases Clinics of North America)
Source: Infectious Diseases Clinics of North America - August 4, 2021 Category: Infectious Diseases Authors: Michael Y. Lin, William E. Trick Source Type: research

Antimicrobial Stewardship and the Infection Control Practitioner
Antibiotic overuse and misuse has contributed to rising rates of multidrug-resistant organisms and Clostridioides difficile. Decreasing antibiotic misuse has become a national public health priority. This review outlines the goals of antimicrobial stewardship, essential members of the program, implementation strategies, approaches to measuring the program ’s impact, and steps needed to build a program. Highlighted is the alliance between antimicrobial stewardship programs and infection prevention programs in their efforts to improve antibiotic use, improve diagnostic stewardship for C difficile and asymptomatic bacteriur...
Source: Infectious Diseases Clinics of North America - August 4, 2021 Category: Infectious Diseases Authors: Shiwei Zhou, Jerod L. Nagel, Keith S. Kaye, Kerry L. LaPlante, Owen R. Albin, Jason M. Pogue Source Type: research

Behind Every Great Infection Prevention Program is a Great Microbiology Laboratory
A great clinical microbiology laboratory supporting a great infection prevention program requires focusing on the following services: rapid and accurate identification of pathogens associated with health care –associated infections; asymptomatic surveillance for health care–acquired pathogens before infections arise; routine use of broad and flexible antimicrobial susceptibility testing to direct optimal therapy; implementation of epidemiologic tracking tools to identify outbreaks; development of cle ar result communication with interpretative comments for clinicians. These goals are best realized in a collaborative re...
Source: Infectious Diseases Clinics of North America - August 4, 2021 Category: Infectious Diseases Authors: Paul Lephart, William LeBar, Duane Newton Source Type: research

Updates on Infection Control in Alternative Health Care Settings
Patients increasingly receive care from a large spectrum of different settings, placing them at risk for exposure to pathogens by many different sources. Each health care environment has its own specific challenges, and thus infection control programs must be tailored to each specific setting. High-turnover outpatient settings may require additional considerations, such as establishing patient triage and follow-up protocols, and broadened cleaning and disinfection procedures. In nursing homes, infection control programs should focus on surveillance for infections and antimicrobial resistance, outbreak investigation and con...
Source: Infectious Diseases Clinics of North America - August 4, 2021 Category: Infectious Diseases Authors: Lisa Sturm, Michelle Flood, Ana Montoya, Lona Mody, Marco Cassone Source Type: research

Health Care –Acquired Infections in Low- and Middle-Income Countries and the Role of Infection Prevention and Control
Health care –associated infections (HAIs) account for many morbidity and mortality worldwide, with disproportionate adverse effects in low- and middle-income countries (LMIC). Many factors contribute to the impact in LMIC, including lack of infrastructure, inconsistent surveillance, deficiency in trained pers onnel and infection control programs, and poverty-related factors. Therefore, optimal approaches must be tailored for LMIC and balance effectiveness and cost in the control of HAIs. (Source: Infectious Diseases Clinics of North America)
Source: Infectious Diseases Clinics of North America - August 4, 2021 Category: Infectious Diseases Authors: Gina Maki, Marcus Zervos Source Type: research

Reimagining Construction and Renovation of Health Care Facilities During Emergence from a Pandemic
This article summarizes known risks and highlights prevention strategies for daily care as well as response to emergent infectious diseases and this parapandemic phase. (Source: Infectious Diseases Clinics of North America)
Source: Infectious Diseases Clinics of North America - August 4, 2021 Category: Infectious Diseases Authors: Russell N. Olmsted Source Type: research

Infection Prevention and Control in Healthcare, Part I: Facility Planning
INFECTIOUS DISEASE CLINICS OF NORTH AMERICA (Source: Infectious Diseases Clinics of North America)
Source: Infectious Diseases Clinics of North America - August 4, 2021 Category: Infectious Diseases Authors: Keith S. Kaye, Sorabh Dhar Source Type: research

Copyright
Elsevier (Source: Infectious Diseases Clinics of North America)
Source: Infectious Diseases Clinics of North America - August 4, 2021 Category: Infectious Diseases Source Type: research

Contributors
HELEN W. BOUCHER, MD, FIDSA, FACP (Source: Infectious Diseases Clinics of North America)
Source: Infectious Diseases Clinics of North America - August 4, 2021 Category: Infectious Diseases Source Type: research