Institute for Continuing Education

Infectious Disease Control and CDC Guidelines

Course Objectives

Upon successful completion of this module, you will be able to:

Course Information

In the United States, there are an estimated 8.8 million persons who work in healthcare professions and about 6 million persons work in more than 6000 hospitals. However, healthcare is increasingly being provided outside hospitals in facilities such as nursing homes, freestanding surgical and outpatient centers, emergency care clinics, and in patients¹ homes or during pre-hospital emergency care. Hospital based personnel and personnel who provide healthcare outside hospitals may acquire infections from or transmit infections to patients, other personnel, household members, or other community contacts.

In this document, the term healthcare personnel refers to all paid and unpaid persons working in healthcare settings who have the potential for exposure to infectious materials, including body substances, contaminated medical supplies and equipment, contaminated environmental surfaces, or contaminated air. These personnel may include but are not limited to emergency medical service personnel, dental personnel, laboratory personnel, autopsy personnel, nurses, nursing assistants, physicians, technicians, therapists, pharmacists, students and trainees, contractual staff not employed by the healthcare facility, and persons not directly involved in patient care but potentially exposed to infectious agents (e.g., clerical, dietary, housekeeping, maintenance, and volunteer personnel). In general, healthcare personnel in or outside hospitals who have contact with patients, body fluids, or specimens have a higher risk of acquiring or transmitting infections than do other healthcare personnel who have only brief casual contact with patients and their environment (e.g., beds, furniture, bathrooms, food trays, medical equipment). Throughout this document, terms are used to describe routes of transmission of infections.

These terms have been fully described in the "Guideline for Isolation Precautions in Hospitals." They are summarized as follows:

direct contact refers to body surface­to­body surface contact and physical transfer of microorganisms between a susceptible host and an infected or colonized person (e.g., while performing oral care or procedures);
indirect contact refers to contact of a susceptible host with a contaminated object (e.g., instruments, hands);
droplet contact refers to conjunctival, nasal, or oral mucosa contact with droplets containing microorganisms generated from an infected person (by coughing, sneezing, and talking, or during certain procedures such as suctioning and bronchoscopy) that are propelled a short distance;
airborne transmission refers to contact with droplet nuclei containing microorganisms that can remain suspended in the air for long periods or to contact with dust particles containing an infectious agent that can be widely disseminated by air currents; and, finally,
common vehicle transmission refers to contact with contaminated items such as food, water, medications, devices, and equipment.

In 1983 the CDC published the "Guideline for Infection Control in Hospital Personnel. The document focused on the prevention of infections known to be transmitted to and from healthcare personnel. This revision of the guideline has been expanded to include

(a) recommendations for non­patient care personnel, both in and outside hospitals,

(b) management of exposures,

(c) prevention of transmission of infections in microbiologic and biomedical laboratories, and, because of the common use of latex barriers to prevent infections,

(d) prevention of latex hypersensitivity reactions.

As in the 1983 guideline, readers are frequently referred to the "Guideline for Isolation Precautions in Hospitals" and other published guidelines and recommendations for precautions that healthcare personnel may use when caring for patients or handling patient equipment or specimens.