No place for infection

Research drives strict patient care guidelines

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Mark Katzman

Victoria J. Fraser, MD, and her team lead infection control training programs in health care and community settings.

Hospital-acquired infections (HAIs) remain a significant cause of illness and death. Too frequently, bacteria or other microorganisms lurking on medical devices, bed rails, a bandage or a caregiver’s hands find their way into a patient’s body via a wound, catheter, ventilator or invasive procedure.

School of Medicine researchers have developed infection surveillance and control guidelines that have been adopted worldwide.

Washington University researchers have developed infection surveillance and control guidelines that have been adopted worldwide.

Despite these measures, new virulent, antibiotic-resistant pathogens such as methicillin-resistant Staphylococcus aureus (MRSA) and Clostridium difficile have emerged. People are living longer, but also are more susceptible to HAIs — through advances in cancer therapy, the use of immunosuppressants and long-term management of multiple chronic diseases. “The key to preventing the spread of infections is vigilance and attention to strict patient care guidelines,” said Victoria J. Fraser, MD, the Adolphus Busch Professor and chair of the Department of Internal Medicine and a world-renowned infectious diseases expert.

Among critical advances made by the medical school’s infectious disease research team and BJC HealthCare Infection Prevention Consortium:

• Safer IV insertion techniques and use of the antibacterial antiseptic chlorhexidine to lower the risk of bloodstream infections. In 10 years, central line-associated bloodstream infections in the U.S. decreased 60 percent.

• Standardized procedures to reduce surgical site infections, including improved hand hygiene, skin antiseptic use, clippers instead of shaving, perioperative glucose control, better temperature control in the operating room and precise timing of antibiotic use.

• Improved patient management policies — including elevating the head of hospital beds, use of disinfectant mouthwashes and standardized order sets to wean patients off ventilators and sedatives — which reduced ventilator-associated pneumonia in ICUs. This campaign, named “Whap VAP,” subsequently was replicated across the country.

Our ability to advance research, recruit the best individuals and train health care workers to protect patients is greatly helped by private

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