Friday, June 20, 2014

What is a health care-associated infection? Is there anything I can do to prevent it?

By Pranavi Sreeramoju, MD, MPH
Infectious Disease Specialist
Associate Professor of Medicine-Infectious Diseases, 
University of Texas Southwestern Medical Center

A health care-associated infection, often called HAI in short, is an infection that a person develops after receiving care in a health care facility. The facility could be any type ― a hospital, clinic, day surgery center, or dialysis center, for example.

The well-known types of HAI are infections associated with catheters (tubes) placed in large veins of the body, urinary tract infections associated with catheters, pneumonia associated with being on a ventilator for life support, infections caused by antibiotic-resistant bacteria, and diarrhea caused by a bacteria called Clostridium difficile. The Centers for Disease Control and Prevention estimates more than 720,000 infections occur every year in the United States, resulting in approximately 75,000 deaths. The infections spread commonly through unclean hands or equipment, or via contaminated air. The health care team is responsible for ensuring care is provided free of contamination and the patient does not develop an HAI.

Patients may carry antibiotic-resistant bacteria, such as methicillin-resistant Staphylococcus aureus (MRSA), on their body and not get sick. This is called a carrier state or colonization. Even if someone is a carrier for a certain bacteria, he or she can develop an HAI from the same bacteria. Just because a patient is colonized with a pathogen does not mean that the burden of prevention is less on the health care team.

Patients and families play a critical role in preventing health care-associated infections. As a patient, it is crucial that you advocate for your own health. First, insist that the health care providers clean their hands every time they touch you. If they forget, help them to remember. Second, pay attention to changes in your health status. If you have a catheter in your body, ask questions about how long you need it, and if you notice any redness at the site, alert someone to the symptom. If you develop diarrhea while taking antibiotics, let your health care provider know. Third, do not ask for antibiotics for common infections like the flu, ear infection, or sinusitis. Finally, speak up and ask questions about your care. Ask why you need a catheter or why you need an antibiotic when you are prescribed one.

Even though the health care team is primarily responsible for preventing a health care-associated infection, you need to remain engaged and advocate for your health.

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