Guidelines for prevention of nosocomial pneumonia

"This document updates and replaces CDC's previously published "Guideline for Prevention of Nosocomial Pneumonia" (Infect Control 1982;3:327-33, Respir Care 1983;28:221-32, and Am J Infect Control 1983;11:230-44). This revised guideline is designed to reduce the incidence of nosocomial pneumonia and is intended for use by personnel who are responsible for surveillance and control of infections in acute-care hospitals; the information may not be applicable in long-term-care facilities because of the unique characteristics of such settings. This revised guideline addresses common problems encountered by infection-control practitioners regarding the prevention and control of nosocomial pneumonia in U.S. hospitals. Sections on the prevention of bacterial pneumonia in mechanically ventilated and/or critically ill patients, care of respiratory-therapy devices, prevention of cross-contamination, and prevention of viral lower respiratory tract infections (e.g., respiratory syncytial virus [RSV] and influenza infections) have been expanded and updated. New sections on Legionnaires disease and pneumonia caused by Aspergillus sp. have been included. Lower respiratory tract infection caused by Mycobacterium tuberculosis is not addressed in this document. Part I, "An Overview of the Prevention of Nosocomial Pneumonia, 1994, provides the background information for the consensus recommendations of the Hospital Infection Control Practices Advisory Committee (HICPAC) in Part II, Recommendations for Prevention of Nosocomial Pneumonia." Pneumonia is the second most common nosocomial infection in the United States and is associated with substantial morbidity and mortality."Includes bibliographical references (p. 67-72)."The following CDC staff members prepared this report:: Ofelia C. Tablan, Larry J. Anderson, Nancy H. Arden, Robert F. Breiman, Jay C. Butler, Michael M. McNeil, Michele L. Pearson, National Center for Infectious Diseases, in collaboration with theHospital Infection Control Practices Advisory Committee." p. v.Part 1. An Overview of the Prevention of Nosocomial Pneumonia, 1994 -- Part II. Recommendations for Preventing Nosocomial Pneumonia -- Appendix A: Examples of Semicritical Items Used on the Respiratory Tract -- Appendix B: Maintenance Procedures Used to Decrease Survival and Multiplication of Legionella sp. in Potable-Water Distribution Systems -- Appendix C: Culturing Environmental Specimens for Legionella sp -- Appendix D: Procedure for Cleaning Cooling Towers and Related Equipment.1997SupersededHICPACPrevention and ControlInfectious Disease903630