Healthcare Associated Infections

What are healthcare associated infections?

Healthcare associated infections (HAI) are infections that are associated with the delivery of healthcare in any setting -including hospitals, long-term care facilities, ambulatory settings, and home care – and that carry a high risk of being due to an antibiotic-resistant organism.

The most common HAIs are Methicillin-Resistant Staphylococcus aureus (MRSA) and Clostridium difficile infection (C. difficile).

What are the risk factors for Methicillin-Resistant Staphylococcus aureus (MRSA)?

Risk factors for acquiring MRSA include:

• Prior antibiotic therapy, surgery, ICU admission, a hospital stay longer than 48 hours.
• History of an indwelling catheter.
• History of an invasive medical device, skin breakdown, and exposure to an MRSA-colonized or MRSA-infected customer or healthcare worker.
• Poor hygiene significantly increases risk for transmission.
• Other risk factors include injection drug use, recent influenza, smoking history, recent antibiotic therapy, skin trauma, higher body mass index.

What are the risk factors for Clostridium difficile infection (C. diff)?

Risk factors for acquiring C. diff include:

• Being over the age of 65 (risk of infection increased by 2 percent each year after age 18).
• Immunocompromised status as are result of antibiotic therapy, chemotherapy, a severe underlying illness, gastrointestinal surgery and/or manipulation or nasogastric intubation.
• Prolonged stay in a healthcare setting.
• Certain conditions such as cystic fibrosis, pancreatitis, liver and renal diseases, and hematologic disorders.
• Customers with inflammatory bowel disease (IBD), like Crohn’s disease or ulcerative colitis, are at increased risk of developing C. diff.

What are the signs and symptoms of healthcare associated infections?

• Customers with MRSA typically present with pneumonia after an influenza-like illness or with a persistent skin and soft tissue infection—common types include boils, furuncles, mastitis, folliculitis, impetigo, hydradenitis suppurativa, and cellulitis—with or without fever.
• Customers with MSRA infection may also present with pneumonia, bloodstream infections, endocarditis, urinary tract infections, and/or surgical site infections.
• The primary clinical manifestations of C. diff are watery or mucus-like diarrhea, loss of appetite, abdominal cramping and/or tenderness, fever, nausea, vomiting, and hypovolemia.

How are healthcare associated infections diagnosed?

To diagnose a healthcare associated infection, your medical team will examine your medical history and may order laboratory tests.

How are healthcare associated infections treated?

Healthcare-associated infections are defined as entities separate from other diseases because they are more likely to be due to multidrug-resistant organisms (MDROs) and require particular treatment strategies with broad-spectrum antibiotics.

Antibiotic choices may be severely limited due to multiple resistance mechanisms; however, prompt initiation of treatment is required in certain HAIs to reduce mortality, often necessitating empiric choices of combination broad-spectrum agents to assure all potential MDROs are covered while awaiting definitive microbiological laboratory studies. This applies particularly to hospital-acquired pneumonia and catheter-related

When should I contact my healthcare provider?

Make an appointment with your doctor if you have any of the following symptoms related to bacterial endocarditis:

• Fever.
• Abdominal cramping and pain, can be severe.
• Watery diarrhea 10-15 times a day.
• Blood or pus in the stool.
• Nausea.
• Dehydration.
• Loss of appetite.
• Weight loss.
• Redness, warmth, swelling, tenderness of the skin and boils and blisters.
• Lethargy.
• Headache.