Page 208 - policy and procedure infection control

Policies and Procedures on Infection Control
Appendix A

CASE DEFINITIONS

DIFINITIONS OF NOSOCOMIAL INFECTIONS FIRST EDITION 2002

This document has been adapted from the CDC Definition of Nosocomial Infections (Garner JS,
Jarvis WR, Emori TG, Horan TC, Hughes JM. CDC definitions for nosocomial infections. In: Olmsted
RN, ed: APIC Infection Control and Applied Epidemiology: Principles and Practice. St. Louis: Mosby;
1196: pp. A-1 to A-20).

Most bacterial nosocomial infections becomes evident 48 hours (i.e., the typical incubation period)
or more after admission. However, because the incubation period varies with the type of pathogen,
nature of infection and the patient’s underlying conditions, each patient must be assessed individually
for evidence that links it to the hospitalization.

The diagnosis of a nosocomial infection is based on a combination of clinical and laboratory
findings.

There are two special situations in which an infection is considered nosocomial:
1. Infection that is acquired in the hospital but does not become evident until after hospital
discharge.
2. Infection in a neonate that results from passage through the birth canal.

There are two special situations in which an infection is not considered nosocomial:
1. Infection that is associated with a complication or extension of infection already present on
admission, unless a change in pathogen or symptoms strongly suggests the acquisition
of a new infection.
2. In an infant an infection that is known or proved to have been acquired transplacentally
(e.g., toxoplasmosis, rubella, cytomegalovirus, or syphilis) and becomes evident at or
before 48 hours after birth.

The standardize definitions are only for the most common nosocomial infections i.e. urinary tract
infection, pneumonia, surgical site infections, blood stream infections and clinical sepsis. For other
nosocomial infections record them as OTHERS and briefly describe the nature of the infection as
best you can.

More definitions will be included in this document in due course.The following pages contain the
criteria to be used for diagnosing the common nosocomial infections. If you are in doubt PLEASE
CONSULT THE ATTENDING DOCTOR OR MICROBIOLOGIST

Ministry of Health Malaysia 197