Journal List > Hanyang Med Rev > v.31(3) > 1044089

Jung: How to Prevent Transmission of Infectious Agents in Healthcare Settings

Abstract

Isolation is a concept that includes all methods to prevent the transmission of infection and to ensure the safety of patients, family members, visitors, and healthcare workers in healthcare settings. There are two tiers of isolation precautions, standard precautions and transmission-based precautions. Standard precautions are intended to be applied to the care of all patients in all healthcare settings, regardless of the suspected or confirmed presence of an infectious agent. Implementation of standard precautions constitutes the primary strategy, including hand hygiene, respiratory hygiene/cough etiquette, use of personal protective equipment depending on the anticipated exposure, safe injection, patient placement, care of the environment and instruments, and worker safety, for the prevention of healthcare-associated transmission of infectious agents among patients and healthcare personnel. Transmission-based precautions are for patients who are known or suspected to be infected or colonized with infectious agents, including certain epidemiologically important pathogens, which require additional control measures to effectively prevent transmission. There are three categories of transmission-based precautions; contact precautions, droplet precautions, and airborne precautions. Transmission-based precautions are used when the routes of transmission are not completely interrupted using standard precautions alone. For some diseases that have multiple routes of transmission, more than one transmission-based precautions category may be used. When used either alone or in combination, they are always used in addition to standard precautions.

Figures and Tables

Table 1
The CDC/HICPAC System for Categorizing Recommendations
hmr-31-190-i001

CDC, centers for disease control and prevention; HICPAC, healthcare infection control practices advisory committee.

References

1. Siegel JD, Rinehart E, Jackson M, Chiarello L. the Healthcare Infection Control Practices Advisory Committee. 2007 Guideline for Isolation Precautions: Preventing Transmission of Infectious Agents in Healthcare Settings [Internet]. c2011. cited 2011 Jun 12. Atlanta(US): Centers for Disease Control and Prevention;Available from:http://www.cdc.gov/ncidod/dhqp/pdf/guidelines/Isolation2007.pdf.
2. Saiman L, Siegel J. Infection control recommendations for patients with cystic fibrosis: microbiology, important pathogens, and infection control practices to prevent patient-to-patient transmission. Infect Control Hosp Epidemiol. 2003. 24:S6–S52.
crossref
3. Zawacki A, O'Rourke E, Potter-Bynoe G, Macone A, Harbarth S, Goldmann D. An outbreak of Pseudomonas aeruginosa pneumonia and bloodstream infection associated with intermittent otitis externa in a healthcare worker. Infect Control Hosp Epidemiol. 2004. 25:1083–1089.
crossref
4. Saiman L, O'Keefe M, Graham PL 3rd, Wu F, Said-Salim B, Kreiswirth B, et al. Hospital transmission of community-acquired methicillin-resistant Staphylococcus aureus among postpartum women. Clin Infect Dis. 2003. 37:1313–1319.
crossref
5. Sarginson RE, Taylor N, Reilly N, Baines PB, Van Saene HK. Infection in prolonged pediatric critical illness: A prospective four-year study based on knowledge of the carrier state. Crit Care Med. 2004. 32:839–847.
crossref
6. Thomsen RW, Hundborg HH, Lervang HH, Johnsen SP, Schonheyder HC, Sorensen HT. Risk of community-acquired pneumococcal bacteremia in patients with diabetes: a population-based case-control study. Diabetes Care. 2004. 27:1143–1147.
7. Rosenberg AL, Seneff MG, Atiyeh L, Wagner R, Bojanowski L, Zimmerman JE. The importance of bacterial sepsis in intensive care unit patients with acquired immunodeficiency syndrome: implications for future care in the age of increasing antiretroviral resistance. Crit Care Med. 2001. 29:548–556.
crossref
8. Malone JL, Ijaz K, Lambert L, Rosencrans L, Phillips L, Tomlinson V, et al. Investigation of healthcare-associated transmission of Mycobacterium tuberculosis among patients with malignancies at three hospitals and at a residential facility. Cancer. 2004. 101:2713–2721.
crossref
9. Bolyard EA, Tablan OC, Williams WW, Pearson ML, Shapiro CN, Deitchmann SD. Guideline for infection control in healthcare personnel, 1998. Hospital Infection Control Practices Advisory Committee. Infect Control Hosp Epidemiol. 1998. 19:407–463.
crossref
10. Chen SY, Anderson S, Kutty PK, Lugo F, McDonald M, Rota PA, et al. Health care-associated measles outbreak in the United States after an importation: challenges and economic impact. J Infect Dis. 2011. 203:1517–1525.
crossref
11. Kimberlin DW. Control of varicella disease, version 2.0. J Infect Dis. 2011. 203:297–299.
crossref
12. Jensen PA, Lambert LA, Iademarco MF, Ridzon R. Guidelines for preventing the transmission of Mycobacterium tuberculosis in health-care settings, 2005. MMWR Recomm Rep. 2005. 54:1–141.
13. Garner JS. Guideline for isolation precautions in hospitals. The Hospital Infection Control Practices Advisory Committee. Infect Control Hosp Epidemiol. 1996. 17:53–80.
14. Update: universal precautions for prevention of transmission of human immunodeficiency virus, hepatitis B virus, and other bloodborne pathogens in health-care settings. MMWR Morb Mortal Wkly Rep. 1988. 37:377–382. 387–388.
15. Lynch P, Cummings MJ, Roberts PL, Herriott MJ, Yates B, Stamm WE. Implementing and evaluating a system of generic infection precautions: body substance isolation. Am J Infect Control. 1990. 18:1–12.
crossref
16. Srinivasan A, McDonald LC, Jernigan D, Helfand R, Ginsheimer K, Jernigan J, et al. Foundations of the severe acute respiratory syndrome preparedness and response plan for healthcare facilities. Infect Control Hosp Epidemiol. 2004. 25:1020–1025.
crossref
17. Weber DJ, Sickbert-Bennett E, Gergen MF, Rutala WA. Efficacy of selected hand hygiene agents used to remove Bacillus atrophaeus (a surrogate of Bacillus anthracis) from contaminated hands. JAMA. 2003. 289:1274–1277.
crossref
18. Hansen S, Stamm-Balderjahn S, Zuschneid I, Behnke M, Ruden H, Vonberg RP, et al. Closure of medical departments during nosocomial outbreaks: data from a systematic analysis of the literature. J Hosp Infect. 2007. 65:348–353.
crossref
19. Wu HM, Fornek M, Schwab KJ, Chapin AR, Gibson K, Schwab E, et al. A norovirus outbreak at a long-term-care facility: the role of environmental surface contamination. Infect Control Hosp Epidemiol. 2005. 26:802–810.
crossref
20. Pinsky BA, Mix S, Rowe J, Ikemoto S, Baron EJ. Long-term shedding of influenza A virus in stool of immunocompromised child. Emerg Infect Dis. 2010. 16:1165–1167.
crossref
21. Sukhrie FH, Siebenga JJ, Beersma MF, Koopmans M. Chronic shedders as reservoir for nosocomial transmission of norovirus. J Clin Microbiol. 2010. 48:4303–4305.
crossref
22. Kroger AT, Atkinson WL, Marcuse EK, Pickering LK. General recommendations on immunization: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep. 2006. 55:1–48.
TOOLS
Similar articles