Guidelines for preventing health-care--associated pneumonia, 2003: recommendations of CDC and the Healthcare Infection Control Practices Advisory Committee
Guidelines for preventing health-care--associated pneumonia, 2003: recommendations of CDC and the Healthcare Infection Control Practices Advisory Committee
1st March 2004
Centers for Disease Control and Prevention - Federal Government Agency [U.S.]
Summary,
DISEASE/CONDITION(S)
Health-care associated infections, including bacterial pneumonia, Legionnaires disease, pertussis, invasive pulmonary aspergillosis (IPA), respiratory syncytial virus (RSV), parainfluenza and adenoviruses, and influenza
Note: Lower respiratory tract infection caused by Mycobacterium tuberculosis is not addressed in this document.
GUIDELINE CATEGORY
Evaluation
Management
Prevention
CLINICAL SPECIALTY
Critical Care
Emergency Medicine
Family Practice
Infectious Diseases
Internal Medicine
Nursing
Preventive Medicine
Pulmonary Medicine
INTENDED USERS
Advanced Practice Nurses
Allied Health Personnel
Clinical Laboratory Personnel
Health Care Providers
Hospitals
Nurses
Physician Assistants
Physicians
Public Health Departments
Respiratory Care Practitioners
GUIDELINE OBJECTIVE(S)
To provide appropriate recommendations for reducing the incidence of pneumonia and other severe, acute lower respiratory tract infections in acute-care hospitals and in other health-care settings (e.g., ambulatory and long-term care institutions) and other facilities where health care is provided
TARGET POPULATION
Patients at risk of pneumonia and other severe, acute lower respiratory tract infections in acute-care hospitals and in other health-care settings
INTERVENTIONS AND PRACTICES CONSIDERED
See the "Major Recommendations" field for additional context.
Specific to Pneumonia
Sterilization or disinfection and maintenance of equipment and devices, specifically respiratory equipment, through cleaning steam sterilization Pneumococcal vaccination
Prevention of aspiration by use of noninvasive ventilation, patient positioning, prevention or modulation of oropharyngeal colonization with an antiseptic agent, and oral rinsing with chlorhexidine gluconate
Prevention of postoperative pneumonia by promoting deep breathing and ambulating and incentive spirometry
Specific to Legionnaires Disease
Infection and environmental surveillance with appropriate laboratory diagnostic testing, including both culture of appropriate respiratory specimens and urine antigen testing
Proper placement of cooling towers in new building construction
Potable water temperature maintained at the outlet at >51°C (>124°F) or <20°C (<68°F),
Decontaminate heated water systems by superheating or hyperchlorination
Specific to Pertussis
Pertussis vaccination
Diagnostic laboratory tests and treatment for healthcare personnel with illness suggestive symptoms
Antibiotic drug administration for persons in close contact with persons with pertussis: macrolides, erythromycin, azithromycin, clarithromycin, trimethoprim-sulfamethoxazole
Specific to Aspergillus
Minimization of fungal spore accumulation via high-efficiency particulate air (HEPA) filtration, directed room airflow, controlled environmental conditions (i.e., carpets, dust, water leaks), and use of antifungal biocides
Plan to prevent exposure when planning construction, demolition, and renovations in and around the facility
Specific to Respiratory Syncytial Virus (RSV)
Administration of monoclonal antibody (palivizumab)
Specific to Influenza
Influenza vaccination
Administration of amantadine, rimantadine, oseltamivir, and zanamivir
MAJOR OUTCOMES CONSIDERED
Incidence of pneumonia and other severe, acute lower respiratory tract infections in acute-care hospitals and in other health-care settings
Centers for Disease Control and Prevention - Federal Government Agency [U.S.]
Summary,
DISEASE/CONDITION(S)Health-care associated infections, including bacterial pneumonia, Legionnaires disease, pertussis, invasive pulmonary aspergillosis (IPA), respiratory syncytial virus (RSV), parainfluenza and adenoviruses, and influenza
Note: Lower respiratory tract infection caused by Mycobacterium tuberculosis is not addressed in this document.
GUIDELINE CATEGORY
Evaluation
Management
Prevention
CLINICAL SPECIALTY
Critical Care
Emergency Medicine
Family Practice
Infectious Diseases
Internal Medicine
Nursing
Preventive Medicine
Pulmonary Medicine
INTENDED USERS
Advanced Practice Nurses
Allied Health Personnel
Clinical Laboratory Personnel
Health Care Providers
Hospitals
Nurses
Physician Assistants
Physicians
Public Health Departments
Respiratory Care Practitioners
GUIDELINE OBJECTIVE(S)
To provide appropriate recommendations for reducing the incidence of pneumonia and other severe, acute lower respiratory tract infections in acute-care hospitals and in other health-care settings (e.g., ambulatory and long-term care institutions) and other facilities where health care is provided
TARGET POPULATION
Patients at risk of pneumonia and other severe, acute lower respiratory tract infections in acute-care hospitals and in other health-care settings
INTERVENTIONS AND PRACTICES CONSIDERED
See the "Major Recommendations" field for additional context.
Specific to Pneumonia
Sterilization or disinfection and maintenance of equipment and devices, specifically respiratory equipment, through cleaning steam sterilization Pneumococcal vaccination
Prevention of aspiration by use of noninvasive ventilation, patient positioning, prevention or modulation of oropharyngeal colonization with an antiseptic agent, and oral rinsing with chlorhexidine gluconate
Prevention of postoperative pneumonia by promoting deep breathing and ambulating and incentive spirometry
Specific to Legionnaires Disease
Infection and environmental surveillance with appropriate laboratory diagnostic testing, including both culture of appropriate respiratory specimens and urine antigen testing
Proper placement of cooling towers in new building construction
Potable water temperature maintained at the outlet at >51°C (>124°F) or <20°C (<68°F),
Decontaminate heated water systems by superheating or hyperchlorination
Specific to Pertussis
Pertussis vaccination
Diagnostic laboratory tests and treatment for healthcare personnel with illness suggestive symptoms
Antibiotic drug administration for persons in close contact with persons with pertussis: macrolides, erythromycin, azithromycin, clarithromycin, trimethoprim-sulfamethoxazole
Specific to Aspergillus
Minimization of fungal spore accumulation via high-efficiency particulate air (HEPA) filtration, directed room airflow, controlled environmental conditions (i.e., carpets, dust, water leaks), and use of antifungal biocides
Plan to prevent exposure when planning construction, demolition, and renovations in and around the facility
Specific to Respiratory Syncytial Virus (RSV)
Administration of monoclonal antibody (palivizumab)
Specific to Influenza
Influenza vaccination
Administration of amantadine, rimantadine, oseltamivir, and zanamivir
MAJOR OUTCOMES CONSIDERED
Incidence of pneumonia and other severe, acute lower respiratory tract infections in acute-care hospitals and in other health-care settings
