TY - CHAP M1 - Book, Section TI - Health Care–Associated Infections A1 - Chandra, Subani A1 - Chong, David A2 - Oropello, John M. A2 - Pastores, Stephen M. A2 - Kvetan, Vladimir Y1 - 1 N1 - T2 - Critical Care AB - KEY POINTSHealth care–associated infections (HCAIs) contribute significantly to morbidity and mortality, and health care costs.The most frequent HAIs are catheter-related bloodstream infections (CRBSIs), ventilator-associated pneumonias (VAPs), infections with Clostridium difficile, surgical site infections (SSIs), and catheter-associated urinary tract infections (CAUTIs).Major preventive strategies to reduce CRBSIs include optimal catheter site selection; proper hand hygiene; maximal barrier precautions at the time of insertion; chlorhexidine skin antisepsis, use of chlorhexidine-impregnated dressings, or use of antiseptic or antimicrobial-coated catheters; tunneled insertion; catheter site care and limited manipulation of the catheter; and daily review of line necessity and prompt removal of unnecessary lines.The most common causes for VAPs are aerobic gram-negative bacilli such as Pseudomonas aeruginosa, Klebsiella pneumoniae, and Acinetobacter species and less commonly gram-positive organisms such as Staphylococcus aureus.C difficile can cause a wide range of disease from asymptomatic infection in a silent carrier state to fulminant disease associated with severe sepsis and death.Essential elements of the SSI bundle include appropriate use of prophylactic antibiotics; appropriate hair removal, controlled postoperative serum glucose in patients after cardiac surgery, and immediate postoperative normothermia in patients with colorectal surgery.The single most significant risk factor for a CAUTI is the prolonged use of the urinary catheter. SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/03/28 UR - accessmedicine.mhmedical.com/content.aspx?aid=1136415477 ER -