Strategies to Prevent S. aureus BSIs in Acute Care Facilities | CDC

Strategies to Prevent S. aureus BSIs in Acute Care Facilities | CDC

1. IMPLEMENT INTERVENTIONS TO REDUCE DEVICE AND PROCEDURE RELATED HEALTHCARE-ASSOCIATED INFECTIONS

• Central line-associated bloodstream infection (CLABSI) prevention practices
  • Core Strategies:
    • Follow evidence-based guidance for the prevention of CLABSIs
      • Available Guidance:
        • CDC Guidelines for the Prevention of Intravascular Catheter-Related Infections, 2011[PDF – 83 pages]
        • SHEA Strategies to Prevent Central Line–Associated Bloodstream Infections in Acute Care Hospitals: 2014 Update
        • CDC Guidance on use of CHG-impregnated dressings:
    • See Table 1 for source control strategies by patient type and setting including for patents with CVCs

• Surgical site infection (SSI) prevention practices
  • Core Strategies:
    • Follow evidence-based guidance for the prevention of SSIs
      • Available guidance:
        • CDC Guidelines for the Prevention of Surgical Site Infection, 2017
        • SHEA Strategies to Prevent Surgical Site Infections in Acute Care Hospitals: 2014 Update
    • For all patients undergoing high risk surgeries (e.g. cardiothoracic (CT), orthopedic, and neurosurgery), unless known to be S. aureus negative,use an intranasal antistaphyloccal antibiotic/antiseptic (e.g. mupirocin or iodophor) and chlorhexidine wash or wipes prior to surgery.
      • Possible Regimens
        • Intranasal antistaphyloccal antibiotic/antiseptic
          • Mupirocin twice daily to each nare for the 5 days prior to day of surgery
          • 2 applications of nasal Iodophor (at least 5%) to each nare within 2 hours prior to surgery
        • Chlorhexidine
          • Daily chlorhexidine wash or wipes for up to 5 days prior to surgery
  • Supplement Strategy
    • Consider chlorhexidine bathing or wipes for up to 5 days prior to surgery for all surgical patients, not just those undergoing high risk surgeries, unless known to be S. aureus negative
• Hemodialysis bloodstream infection prevention practices
  • Core Strategy:
    • Follow evidence-based guidance for the prevention of hemodialysis bloodstream infections
      • Available guidance:
        • CDC Approach to BSI Prevention in Dialysis Facilities[PDF – 1 page]
• Ventilator-associated Pneumonia (VAP) prevention practices
  • Core Strategy:
    • Follow evidence-based guidance for the prevention of VAP
      • Available guidance:
        • SHEA Strategies to Prevent Ventilator-Associated Pneumonia in Acute Care Hospitals: 2014 Update.