- Email: [email protected]
New guidelines for infection control
General infornlation (disease. vaccine, and indication\ for vaccination) Administration (adult and pediatric dosing, route, and schedule) Side effects Precautions and contraindications Compatibility Special considerations Schedules for vaccinating travelers
Advisor:\. Committee (HICPAC). This Treatment Guidelines for report reviews previous guidelines and Tuberculosis strategies for preventing environmentThis past summer the American associated infections in health care Thoracic Society, the CDC. and the facilities and presents new recommenInfectious Diseases Society of America dations. These recommendations (i) published detailed recommendations to are evidence-based, (ii) consider the guide health care practitioners in the requirements of federal agencies , (iii) treatment of tuberculosis in settings address the guidelines and standards where mycobacterial (Mtb) cultures, from building and equipment profesdrug susceptibility testing, radiographic sional Organizations. and (iv) are derfacilities, and second-line drugs are The book is available from ived from scientific theory or rationale routinely available. New information Shoreland Press (Milwaukee, WI), contained in this document includes and experienced opinions based upon n,~~w:.sho/-~/c~rzrl.c.orll. or the APHA. (i) assignment of responsibility for sucinfection-control and engineering pracRescreening for Chlamydial cessful treatment to the public health tices. The report also suggests a series Infection and Gonorrhea program or private provider. not to of performance measurements as a The CDC 2002 sexually transmitted the patient, (ii) patient-centered case means to evaluate infection control disease (STD) treatment guidelines management emphasizing direct obserefforts. ,~~~~~II:c~d~~.go~~~/lll/nM~r/~-/l’r~~i~~~l~/ recommend that clinicians to consider vation of therapy (DOT), (iii) the nec~t~~rr~~~~/it~~il/~r52IO~iI.l~t~~z advising all women with chlamydial essity to obtain sputum cultures at the CDC Recommendations for infection to be rescreened 3 to 4 months time of completion of the initial phase Detecting Legionehe in the after treatment. Rescreening differs of treatment, (iv) therapeutic modalities. from test-of-cure in that it occurs later Environment including agents and administration, and is based upon the fact that persons Although the CDC recommends and (v) special treatment situations. e.g.. diagnosed with STDs are at high risk aggressive disinfection measures for the presence of cavitation, HIV infecfor acquiring STDs in the future. The tion. tuberculosis in children, extrapucleaning and maintaining devices CDC does not recommend test-of-cure known to transmit legionellae, the monary tuberculosis, culture-negative for either gonorrhea or chlamydial tuberculosis. hepatic and renal disease. agency does not recommend regularly infection in patients receiving standard and drug-resistant organisms. These scheduled microbiologic assays for the treatment regimens. except in the case recommendations are compared with bacteria. However. scheduled monitorof women who are pregnant. This those of the WHO and the International ing of potable water within a hospital change in the recommended manageUnion against Tuberculosis (IUATB). might be considered in certain settings ment of chlamydial infection reflects The DOT strategy is described. and the where pcr\ons are highly susceptible to the changing epidemiolpgy of bacterial current status of research to improve il tness and mortality from Legionello STD. in the United States and several treatment is re\,iewed. In areas where infection or in unique situations, such other factors. Over the past decade. certain diagnostic resources are not as after an outbreak of tegionellosis. changes in the epidemiology of bacteravailable (culture, susceptibility testing, Examination of water samples is the ial STD. have provided an impetus for X ray, or first-line drugs). the recotnmost efficient microbiologic method reconsidering rescreening in specific mendations provided by the WHO or for identifying sources of legionellae groups. In addition. changes in diagnosthe IUATB should be followed. The and is an integral part of an epidemio. tic microbiology may make rescreening complete guideline can be seen at KNN: logic investigation into health careeasier to implement than it was in the c~~.go~/t~ltn~t~r/~~re~~i~~~~~/~lt~l~~~rl~tt~zl/ associated Legionnaires’ disease. Any 1970s. Men should also be rescreened t-l-52lIcll.htrll. uater source that might be aerosotized for gonorrhea and chlamydial infection. should he considered a potential source Workshop on Microbial though the evidence supporting this for transmission of legionellae. The Resistance recommendation is not as strong. bacteria are rarely found in municipal The Institute of Medicine (IOM) rl.~r’Lt:rne~I.Pc~i~~cI,P.(.Oil/~~ie~~~~irti~~l~~/45~40.~ water supplies but tend to colonize recently published a summary of its :?nzpid=16093& W~hLogic,Sr.r.sior7=P=l,,r: plumbing systems and point-of-use 2-day workshop on “The Resistance Y.~CM~~~Q~~~~MHR~~~~/GTSL>I~~NIG~!\ devices; air-conditioning equipment Phenomenon in Microbes and InfectiuZbrJQee\,VJgFG20~k.~jI529/5938226 condensate. which frequently evapoous Disease Vectors: Implications for h2743207/184/h/392/fi/7001/7001/7~~10 rate\, is not a likely source. Water samHuman Health and Strategies for Con2/7002/700 I/- I ples and swabs from point-of-use tainment.” The workshop was organized New Guidelines for Infection devices or system surfaces should be by IOM’s Forum on Emerging Infeccollected when sampling for legionelControl tions. The workshop addresses a variety lat. Details on the collection, transport, of issues relating to antimicrobial resisThe CDC recently published its and processing of water samples and Guidelirzes,fi)r Ern~iromler~t~~lInftictiotl tance: individual differences in pathoswabs are available at ~~w.cdc.,qo~~/ Control in Henltil-Cctw Futilities: gens; mode of action of antimicrobial tllrll,~~r./l~/.e~~ie~~~/~~l/?z~~rht~~~l/rr52lOa2agents: mechanisms of resistance; the Re~onlnlenck~tior1.sof CDC trrd thr .htnr. effects of therapeutic regimens, inctudHealtllcnr~~Ir$xtim Control Prwticw
Advisor:\. Committee (HICPAC). This Treatment Guidelines for report reviews previous guidelines and Tuberculosis strategies for preventing environmentThis past summer the American associated infections in health care Thoracic Society, the CDC. and the facilities and presents new recommenInfectious Diseases Society of America dations. These recommendations (i) published detailed recommendations to are evidence-based, (ii) consider the guide health care practitioners in the requirements of federal agencies , (iii) treatment of tuberculosis in settings address the guidelines and standards where mycobacterial (Mtb) cultures, from building and equipment profesdrug susceptibility testing, radiographic sional Organizations. and (iv) are derfacilities, and second-line drugs are The book is available from ived from scientific theory or rationale routinely available. New information Shoreland Press (Milwaukee, WI), contained in this document includes and experienced opinions based upon n,~~w:.sho/-~/c~rzrl.c.orll. or the APHA. (i) assignment of responsibility for sucinfection-control and engineering pracRescreening for Chlamydial cessful treatment to the public health tices. The report also suggests a series Infection and Gonorrhea program or private provider. not to of performance measurements as a The CDC 2002 sexually transmitted the patient, (ii) patient-centered case means to evaluate infection control disease (STD) treatment guidelines management emphasizing direct obserefforts. ,~~~~~II:c~d~~.go~~~/lll/nM~r/~-/l’r~~i~~~l~/ recommend that clinicians to consider vation of therapy (DOT), (iii) the nec~t~~rr~~~~/it~~il/~r52IO~iI.l~t~~z advising all women with chlamydial essity to obtain sputum cultures at the CDC Recommendations for infection to be rescreened 3 to 4 months time of completion of the initial phase Detecting Legionehe in the after treatment. Rescreening differs of treatment, (iv) therapeutic modalities. from test-of-cure in that it occurs later Environment including agents and administration, and is based upon the fact that persons Although the CDC recommends and (v) special treatment situations. e.g.. diagnosed with STDs are at high risk aggressive disinfection measures for the presence of cavitation, HIV infecfor acquiring STDs in the future. The tion. tuberculosis in children, extrapucleaning and maintaining devices CDC does not recommend test-of-cure known to transmit legionellae, the monary tuberculosis, culture-negative for either gonorrhea or chlamydial tuberculosis. hepatic and renal disease. agency does not recommend regularly infection in patients receiving standard and drug-resistant organisms. These scheduled microbiologic assays for the treatment regimens. except in the case recommendations are compared with bacteria. However. scheduled monitorof women who are pregnant. This those of the WHO and the International ing of potable water within a hospital change in the recommended manageUnion against Tuberculosis (IUATB). might be considered in certain settings ment of chlamydial infection reflects The DOT strategy is described. and the where pcr\ons are highly susceptible to the changing epidemiolpgy of bacterial current status of research to improve il tness and mortality from Legionello STD. in the United States and several treatment is re\,iewed. In areas where infection or in unique situations, such other factors. Over the past decade. certain diagnostic resources are not as after an outbreak of tegionellosis. changes in the epidemiology of bacteravailable (culture, susceptibility testing, Examination of water samples is the ial STD. have provided an impetus for X ray, or first-line drugs). the recotnmost efficient microbiologic method reconsidering rescreening in specific mendations provided by the WHO or for identifying sources of legionellae groups. In addition. changes in diagnosthe IUATB should be followed. The and is an integral part of an epidemio. tic microbiology may make rescreening complete guideline can be seen at KNN: logic investigation into health careeasier to implement than it was in the c~~.go~/t~ltn~t~r/~~re~~i~~~~~/~lt~l~~~rl~tt~zl/ associated Legionnaires’ disease. Any 1970s. Men should also be rescreened t-l-52lIcll.htrll. uater source that might be aerosotized for gonorrhea and chlamydial infection. should he considered a potential source Workshop on Microbial though the evidence supporting this for transmission of legionellae. The Resistance recommendation is not as strong. bacteria are rarely found in municipal The Institute of Medicine (IOM) rl.~r’Lt:rne~I.Pc~i~~cI,P.(.Oil/~~ie~~~~irti~~l~~/45~40.~ water supplies but tend to colonize recently published a summary of its :?nzpid=16093& W~hLogic,Sr.r.sior7=P=l,,r: plumbing systems and point-of-use 2-day workshop on “The Resistance Y.~CM~~~Q~~~~MHR~~~~/GTSL>I~~NIG~!\ devices; air-conditioning equipment Phenomenon in Microbes and InfectiuZbrJQee\,VJgFG20~k.~jI529/5938226 condensate. which frequently evapoous Disease Vectors: Implications for h2743207/184/h/392/fi/7001/7001/7~~10 rate\, is not a likely source. Water samHuman Health and Strategies for Con2/7002/700 I/- I ples and swabs from point-of-use tainment.” The workshop was organized New Guidelines for Infection devices or system surfaces should be by IOM’s Forum on Emerging Infeccollected when sampling for legionelControl tions. The workshop addresses a variety lat. Details on the collection, transport, of issues relating to antimicrobial resisThe CDC recently published its and processing of water samples and Guidelirzes,fi)r Ern~iromler~t~~lInftictiotl tance: individual differences in pathoswabs are available at ~~w.cdc.,qo~~/ Control in Henltil-Cctw Futilities: gens; mode of action of antimicrobial tllrll,~~r./l~/.e~~ie~~~/~~l/?z~~rht~~~l/rr52lOa2agents: mechanisms of resistance; the Re~onlnlenck~tior1.sof CDC trrd thr .htnr. effects of therapeutic regimens, inctudHealtllcnr~~Ir$xtim Control Prwticw