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Health care–associated infections affect as many as 1.7 million patients at a cost of ~$10–33 billion and up to 99,000 lives in U.S. hospitals annually. Although efforts to lower infection risks are challenged by numbers of immunocompromised patients, antibiotic-resistant bacteria, and fungal and viral superinfections, a prevailing viewpoint—”zero tolerance”—is that health care–associated infections are avoidable with strict application of evidence-based prevention guidelines (Table 137-1). In fact, rates of most device-related infections—historically, the largest drivers of risk—have fallen steadily over the past few years. Unfortunately, at the same time, antimicrobial-resistant pathogens have risen in number and are estimated to contribute to ~23,000 deaths annually. This chapter reviews health care–associated and device-related infections as well as basic surveillance, prevention, control, and treatment activities.
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