Abstract
Due to the nature of their underlying illness and treatment regimens, cancer patients are at increased risk of infection. Though the advent and widespread use of anti-infective agents has allowed for the application of ever-greater immune-suppressing therapies with successful treatment of infectious complications, prevention of infection remains the primary goal. The evolutionary changes of microorganisms, whereby resistance to anti-infective therapy is increasingly common, have facilitated a paradigm shift in the field of healthcare epidemiology. No longer is the focus on “control” of infection once established in a healthcare environment. Rather, the emphasis is on prevention of infection before it occurs. The most basic tenet of infection prevention, and the cornerstone of all well-designed infection prevention and control programs, is hand hygiene. The hands of healthcare workers provide a common potential source for transmission of infectious agents, and effective decontamination of the hands reduces the risk of transmission of infectious material to other patients. Once infection is suspected or established; however, implementation of effective control strategies is important to limit the spread of infection within a healthcare environment. This chapter outlines the basic tenets of infection prevention, principles of isolation precautions and control measures, and elements for a successful infection control and prevention program.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
CDC (1992) The nation’s prevention agency. MMWR Morb Mortal Wkly Rep 41(44):833
Hugonnet S, Pittet D (2000) Hand hygiene-beliefs or science? Clin Microbiol Infect 6(7):350–356
Talbot TR et al (2013) Sustained improvement in hand hygiene adherence: utilizing shared accountability and financial incentives. Infect Control Hosp Epidemiol 34(11):1129–1136
Schneider J et al (2009) Hand hygiene adherence is influenced by the behavior of role models. Pediatr Crit Care Med 10(3):360–363
Lankford MG et al (2003) Influence of role models and hospital design on hand hygiene of healthcare workers. Emerg Infect Dis 9(2):217–223
Siegel JD et al (2007) Guideline for isolation precautions: preventing transmission of infectious agents in health care settings. Am J Infect Control 35(10(2)):S65–S164
Use of Surgical Masks and Respirators in Health Care Settings (2010) Oct 2006 (cited 26 Apr 2010). Available from www.pandemicflu.gov/professional/hospital/maskguidancehc.html
Bean B, Braun C, Balfour HH Jr (1982) Acyclovir therapy for acute herpes zoster. Lancet 2(8290):118–121
Leclair JM et al (1980) Airborne transmission of chickenpox in a hospital. N Engl J Med 302(8):450–453
Papineni RS, Rosenthal FS (1997) The size distribution of droplets in the exhaled breath of healthy human subjects. J Aerosol Med 10(2):105–116
Feigin RD et al (1982) Epidemic meningococcal disease in an elementary-school classroom. N Engl J Med 307(20):1255–1257
Dick EC et al (1987) Aerosol transmission of rhinovirus colds. J Infect Dis 156(3):442–448
Siegel JD et al (2007) Management of multidrug-resistant organisms in health care settings, 2006. Am J Infect Control 35(10(2)):S165–S193
Moody K, Charlson ME, Finlay J (2002) The neutropenic diet: what’s the evidence? J Pediatr Hematol Oncol 24(9):717–721
Pizzo PA, Purvis DS, Waters C (1982) Microbiological evaluation of food items. For patients undergoing gastrointestinal decontamination and protected isolation. J Am Diet Assoc 81(3):272–279
Schlesinger A et al (2009) Infection-control interventions for cancer patients after chemotherapy: a systematic review and meta-analysis. Lancet Infect Dis 9(2):97–107
Dykewicz CA, Jaffe HW, Kaplan JE (2000) Guidelines for preventing opportunistic infections among hematopoietic stem cell transplant recipients. MMWR Recomm Rep 49(RR-10):1–125, CE 1–7
Supriya M et al (2009) Controlling MRSA in head and neck cancer patients: what works? Otolaryngol Head Neck Surg 140(2):224–227
Reitzel RA et al (2009) Efficacy of novel antimicrobial gloves impregnated with antiseptic dyes in preventing the adherence of multidrug-resistant nosocomial pathogens. Am J Infect Control 37(4):294–300 (Epub 19 Jan 2009)
Wenzel RP, Bearman G, Edmond MB (2008) Screening for MRSA: a flawed hospital infection control intervention. Infect Control Hosp Epidemiol 29(11):1012–1018
Wang FD et al (2008) Risk factors and mortality in patients with nosocomial Staphylococcus aureus bacteremia. Am J Infect Control 36(2):118–122
Rogers SN et al (2008) Which patients are most at risk of methicillin resistant Staphylococcus aureus: a review of admissions to a regional maxillofacial ward between 2001 and 2005. Br J Oral Maxillofac Surg 46(6):439–444
Hidron AI et al (2008) NHSN annual update: antimicrobial-resistant pathogens associated with healthcare-associated infections: annual summary of data reported to the National Healthcare Safety Network at the Centers for Disease Control and Prevention, 2006–2007. Infect Control Hosp Epidemiol 29(11):996–1011
Miyake M et al (2007) Risk factors for methicillin-resistant Staphylococcus aureus (MRSA) and use of a nasal mupirocin ointment in oral cancer inpatients. J Oral Maxillofac Surg 65(11):2159–2163
Scudeller L et al (2000) MRSA carriage: the relationship between community and healthcare setting. A study in an Italian hospital. J Hosp Infect 46(3):222–229
Robicsek A et al (2008) Universal surveillance for methicillin-resistant Staphylococcus aureus in 3 affiliated hospitals. Ann Intern Med 148(6):409–418
Harbarth S et al (2008) Universal screening for methicillin-resistant Staphylococcus aureus at hospital admission and nosocomial infection in surgical patients. JAMA 299(10):1149–1157
Cosgrove SE et al (2003) Comparison of mortality associated with methicillin-resistant and methicillin-susceptible Staphylococcus aureus bacteremia: a meta-analysis. Clin Infect Dis 36(1):53–59
Worth LJ et al (2007) Vancomycin-resistant Enterococcus faecium infection in patients with hematologic malignancy: patients with acute myeloid leukemia are at high-risk. Eur J Haematol 79(3):226–233
Huang SS et al (2007) Improving the assessment of vancomycin-resistant enterococci by routine screening. J Infect Dis 195(3):339–346
Matar MJ et al (2006) Colonization and infection with vancomycin-resistant Enterococcus among patients with cancer. Am J Infect Control 34(8):534–536
Knoll M et al (2005) Outbreak of vancomycin-resistant enterococci (VRE) in a hematological oncology ward and hygienic preventive measures. A long-term study. Onkologie 28(4):187–192
Oh HS et al (2004) Outbreak of vancomycin resistant Enterococcus in a hematology/oncology unit in a Korean University Hospital, and risk factors related to patients, staff, hospital care and facilities. Scand J Infect Dis 36(11–12):790–794
Husni R et al (2002) Risk factors for vancomycin-resistant Enterococcus (VRE) infection in colonized patients with cancer. Infect Control Hosp Epidemiol 23(2):102–103
Hanna H et al (2001) Management of an outbreak of vancomycin-resistant Enterococci in the medical intensive care unit of a cancer center. Infect Control Hosp Epidemiol 22(4):217–219
McCarthy KM et al (2000) Control of an outbreak of vancomycin-resistant Enterococcus faecium in an oncology ward in South Africa: effective use of limited resources. J Hosp Infect 44(4):294–300
Kuehnert MJ et al (1999) Association between mucositis severity and vancomycin-resistant enterococcal bloodstream infection in hospitalized cancer patients. Infect Control Hosp Epidemiol 20(10):660–663
Roord JJ et al (1986) Infection prevention during induction of remission in children with newly diagnosed acute leukemia. Ann Ist Super Sanita 22(3):973–977
Olivier CN et al (2008) Risk of vancomycin-resistant Enterococcus (VRE) bloodstream infection among patients colonized with VRE. Infect Control Hosp Epidemiol 29(5):404–409
Fuller RE et al (1998) Vancomycin-resistant enterococci: risk related to the use of intravenous vancomycin in a university hospital. Infect Control Hosp Epidemiol 19(11):821–823
Sakka V et al (2008) Risk-factors and predictors of mortality in patients colonised with vancomycin-resistant enterococci. Clin Microbiol Infect 14(1):14–21
Dan M et al (1999) Rectal colonization with vancomycin-resistant enterococci among high-risk patients in an Israeli hospital. J Hosp Infect 43(3):231–238
Beltrami EM et al (2000) Risk factors for acquisition of vancomycin-resistant enterococci among patients on a renal ward during a community hospital outbreak. Am J Infect Control 28(4):282–285
MacIntyre CR et al (2001) Risk factors for colonization with vancomycin-resistant enterococci in a Melbourne hospital. Infect Control Hosp Epidemiol 22(10):624–629
Zaas AK et al (2002) Risk factors for development of vancomycin-resistant enterococcal bloodstream infection in patients with cancer who are colonized with vancomycin-resistant enterococci. Clin Infect Dis 35(10):1139–1146
Martinez JA et al (2003) Role of environmental contamination as a risk factor for acquisition of vancomycin-resistant enterococci in patients treated in a medical intensive care unit. Arch Intern Med 163(16):1905–1912
Padiglione AA et al (2003) Risk factors for new detection of vancomycin-resistant enterococci in acute-care hospitals that employ strict infection control procedures. Antimicrob Agents Chemother 47(8):2492–2498
McEvoy SP et al (2006) Risk factors for the acquisition of vancomycin-resistant enterococci during a single-strain outbreak at a major Australian teaching hospital. J Hosp Infect 62(2):256–258
Assadian O et al (2007) Prevalence of vancomycin-resistant enterococci colonization and its risk factors in chronic hemodialysis patients in Shiraz. Iran BMC Infect Dis 7:52
Askarian M et al (2008) Risk factors for rectal colonization with vancomycin-resistant enterococci in Shiraz. Iran Int J Infect Dis 12(2):171–175
Dubberke ER et al (2006) Vancomycin-resistant enterococcal bloodstream infections on a hematopoietic stem cell transplant unit: are the sick getting sicker? Bone Marrow Transplant 38(12):813–819
Han SH et al (2009) Vancomycin-resistant enterococci bacteremia: risk factors for mortality and influence of antimicrobial therapy on clinical outcome. J Infect 58(3):182–190
DiazGranados CA et al (2005) Comparison of mortality associated with vancomycin-resistant and vancomycin-susceptible enterococcal bloodstream infections: a meta-analysis. Clin Infect Dis 41(3):327–333
DiazGranados CA, Jernigan JA (2005) Impact of vancomycin resistance on mortality among patients with neutropenia and enterococcal bloodstream infection. J Infect Dis 191(4):588–595
Weinstock DM et al (2007) Colonization, bloodstream infection, and mortality caused by vancomycin-resistant enterococcus early after allogeneic hematopoietic stem cell transplant. Biol Blood Marrow Transplant 13(5):615–621
Siddiqui AH et al (2002) The effect of active surveillance for vancomycin-resistant enterococci in high-risk units on vancomycin-resistant enterococci incidence hospital-wide. Am J Infect Control 30(1):40–43
Livermore DM (2009) Has the era of untreatable infections arrived? J Antimicrob Chemother 64(1):i29–i36
Hawkey PM, Jones AM (2009) The changing epidemiology of resistance. J Antimicrob Chemother 64(1):i3–i10
Gould IM (2008) The epidemiology of antibiotic resistance. Int J Antimicrob Agents 32(1):S2–S9
Septimus EJ, Kuper KM (2009) Clinical challenges in addressing resistance to antimicrobial drugs in the twenty-first century. Clin Pharmacol Ther 86(3):336–339
Walsh TR (2008) Clinically significant carbapenemases: an update. Curr Opin Infect Dis 21(4):367–371
Falagas ME, Bliziotis IA (2006) Attributable mortality of Acinetobacter baumannii infections in critically ill patients: a systematic review of matched cohort and case-control studies. Crit Care 10(2):R48
Falagas ME et al (2009) Attributable mortality of Stenotrophomonas maltophilia infections: a systematic review of the literature. Future Microbiol 4:1103–1109
Falagas ME, Kopterides P, Siempos II (2006) Attributable mortality of Acinetobacter baumannii infection among critically ill patients. Clin Infect Dis 43(3):389; author reply 389–390
Furtado GH et al (2009) Imipenem-resistant Pseudomonas aeruginosa infection at a medical-surgical intensive care unit: Risk factors and mortality. J Crit Care 24(4):625 (epub 9 Jul 2009, e9–e14)
Hakki M et al (2007) Invasive Pseudomonas aeruginosa infections: high rate of recurrence and mortality after hematopoietic cell transplantation. Bone Marrow Transplant 39(11):687–693
Krcmery V Jr et al (1998) Bacteremia due to multiresistant gram-negative bacilli in neutropenic cancer patients: a case controlled study. J Chemother 10(4):320–325
Zavascki AP et al (2006) The influence of metallo-beta-lactamase production on mortality in nosocomial Pseudomonas aeruginosa infections. J Antimicrob Chemother 58(2):387–392
Zavascki AP et al (2006) Reappraisal of Pseudomonas aeruginosa hospital-acquired pneumonia mortality in the era of metallo-beta-lactamase-mediated multidrug resistance: a prospective observational study. Crit Care 10(4):R114
Daniels TL et al (2008) Mortality rates associated with multidrug-resistant Acinetobacter baumannii infection in surgical intensive care units. Infect Control Hosp Epidemiol 29(11):1080–1083
Sunenshine RH et al (2007) Multidrug-resistant Acinetobacter infection mortality rate and length of hospitalization. Emerg Infect Dis 13(1):97–103
Morrell M, Fraser VJ, Kollef MH (2005) Delaying the empiric treatment of candida bloodstream infection until positive blood culture results are obtained: a potential risk factor for hospital mortality. Antimicrob Agents Chemother 49(9):3640–3645
Lodise TP Jr et al (2007) Predictors of 30-day mortality among patients with Pseudomonas aeruginosa bloodstream infections: impact of delayed appropriate antibiotic selection. Antimicrob Agents Chemother 51(10):3510–3515
Kollef MH et al (1999) Inadequate antimicrobial treatment of infections: a risk factor for hospital mortality among critically ill patients. Chest 115(2):462–474
Reddy P et al (2007) Screening for extended-spectrum beta-lactamase-producing Enterobacteriaceae among high-risk patients and rates of subsequent bacteremia. Clin Infect Dis 45(7):846–852
Santos RP, Mayo TW, Siegel JD (2008) Healthcare epidemiology: active surveillance cultures and contact precautions for control of multidrug-resistant organisms: ethical considerations. Clin Infect Dis 47(1):110–116
Maragakis LL et al (2008) Incidence and prevalence of multidrug-resistant acinetobacter using targeted active surveillance cultures. JAMA 299(21):2513–2514
Bartlett JG et al (1978) Antibiotic-associated pseudomembranous colitis due to toxin-producing clostridia. N Engl J Med 298(10):531–534
Johnson S et al (1990) Nosocomial Clostridium difficile colonisation and disease. Lancet 336(8707):97–100
Kuijper EJ et al (2001) Nosocomial outbreak of Clostridium difficile-associated diarrhoea due to a clindamycin-resistant enterotoxin A-negative strain. Eur J Clin Microbiol Infect Dis 20(8):528–534
Muto CA et al (2005) A large outbreak of Clostridium difficile-associated disease with an unexpected proportion of deaths and colectomies at a teaching hospital following increased fluoroquinolone use. Infect Control Hosp Epidemiol 26(3):273–280
Mekonen ET et al (2002) Predominance of a single restriction endonuclease analysis group with intrahospital subgroup diversity among Clostridium difficile isolates at two Chicago hospitals. Infect Control Hosp Epidemiol 23(11):648–652
Manian FA, Meyer L, Jenne J (1996) Clostridium difficile contamination of blood pressure cuffs: a call for a closer look at gloving practices in the era of universal precautions. Infect Control Hosp Epidemiol 17(3):180–182
Kaatz GW et al (1988) Acquisition of Clostridium difficile from the hospital environment. Am J Epidemiol 127(6):1289–1294
Brooks S et al (1998) Reduction in vancomycin-resistant Enterococcus and Clostridium difficile infections following change to tympanic thermometers. Infect Control Hosp Epidemiol 19(5):333–336
Gaynes R et al (2004) Outbreak of Clostridium difficile infection in a long-term care facility: association with gatifloxacin use. Clin Infect Dis 38(5):640–645
Komatsu M et al (2003) High frequency of antibiotic-associated diarrhea due to toxin A-negative, toxin B-positive Clostridium difficile in a hospital in Japan and risk factors for infection. Eur J Clin Microbiol Infect Dis 22(9):525–529
Pulvirenti JJ et al (2002) Difference in the incidence of Clostridium difficile among patients infected with human immunodeficiency virus admitted to a public hospital and a private hospital. Infect Control Hosp Epidemiol 23(11):641–647
Talon D et al (1995) Use of pulsed-field gel electrophoresis for investigation of an outbreak of Clostridium difficile infection among geriatric patients. Eur J Clin Microbiol Infect Dis 14(11):987–993
McFarland LV, Surawicz CM, Stamm WE (1990) Risk factors for Clostridium difficile carriage and C. difficile-associated diarrhea in a cohort of hospitalized patients. J Infect Dis 162(3):678–684
Brown E et al (1990) Risk factors for Clostridium difficile toxin-associated diarrhea. Infect Control Hosp Epidemiol 11(6):283–290
Safdar N, Maki DG (2002) The commonality of risk factors for nosocomial colonization and infection with antimicrobial-resistant Staphylococcus aureus, Enterococcus, gram-negative bacilli, Clostridium difficile, and Candida. Ann Intern Med 136(11):834–844
Blot E et al (2003) Outbreak of Clostridium difficile-related diarrhoea in an adult oncology unit: risk factors and microbiological characteristics. J Hosp Infect 53(3):187–192
Gifford AH, Kirkland KB (2006) Risk factors for Clostridium difficile-associated diarrhea on an adult hematology-oncology ward. Eur J Clin Microbiol Infect Dis 25(12):751–755
McDonald LC et al (2005) An epidemic, toxin gene-variant strain of Clostridium difficile. N Engl J Med 353(23):2433–2441
Warny M et al (2005) Toxin production by an emerging strain of Clostridium difficile associated with outbreaks of severe disease in North America and Europe. Lancet 366(9491):1079–1084
Kuijper EJ et al (2008) Update of Clostridium difficile infection due to PCR ribotype 027 in Europe. Euro Surveill 13(31)
Boone N et al (1998) Evaluation of an interdisciplinary re-isolation policy for patients with previous Clostridium difficile diarrhea. Am J Infect Control 26(6):584–587
Hanna H et al (2000) Control of nosocomial Clostridium difficile transmission in bone marrow transplant patients. Infect Control Hosp Epidemiol 21(3):226–228
Delmee M et al (1987) Epidemiology and prevention of Clostridium difficile infections in a leukemia unit. Eur J Clin Microbiol 6(6):623–627
Sherertz RJ et al (1987) Impact of air filtration on nosocomial Aspergillus infections. Unique risk of bone marrow transplant recipients. Am J Med 83(4):709–718
Sehulster L, Chinn RY (2003) Guidelines for environmental infection control in health-care facilities. Recommendations of CDC and the Healthcare Infection Control Practices Advisory Committee (HICPAC). MMWR Recomm Rep 52(RR-10):1–42
Haiduven D (2009) Nosocomial aspergillosis and building construction. Med Mycol 47(1):S210–S216
Maschmeyer G, Haas A, Cornely OA (2007) Invasive aspergillosis: epidemiology, diagnosis and management in immunocompromised patients. Drugs 67(11):1567–1601
Carter CD, Barr BA (1997) Infection control issues in construction and renovation. Infect Control Hosp Epidemiol 18(8):587–596
Gustafson TL et al (1983) Invasive aspergillosis in renal transplant recipients: correlation with corticosteroid therapy. J Infect Dis 148(2):230–238
Palmore TN et al (2009) A cluster of cases of nosocomial legionnaires disease linked to a contaminated hospital decorative water fountain. Infect Control Hosp Epidemiol 30(8):764–768
Meletis J et al (1987) Legionnaires’ disease after bone marrow transplantation. Bone Marrow Transplant 2(3):307–313
Parry MF et al (1985) Waterborne Legionella bozemanii and nosocomial pneumonia in immunosuppressed patients. Ann Intern Med 103(2):205–210
Neill MA et al (1985) Nosocomial legionellosis, Paris, France. Evidence for transmission by potable water. Am J Med 78(4):581–588
Arnow PM et al (1982) Nosocomial Legionnaires’ disease caused by aerosolized tap water from respiratory devices. J Infect Dis 146(4):460–467
Garbe PL et al (1985) Nosocomial Legionnaires’ disease. Epidemiologic demonstration of cooling towers as a source. JAMA 254(4):521–524
Levin AS (2009) Nosocomial legionellosis: prevention and management. Expert Rev Anti Infect Ther 7(1):57–68
Fiore AE et al (2009) Prevention and control of seasonal influenza with vaccines: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep 58(RR-8):1–52
Talbot TR et al (2005) Influenza vaccination of healthcare workers and vaccine allocation for healthcare workers during vaccine shortages. Infect Control Hosp Epidemiol 26(11):882–890
Lemaitre M et al (2009) Effect of influenza vaccination of nursing home staff on mortality of residents: a cluster-randomized trial. J Am Geriatr Soc 57(9):1580–1586
Hayward AC et al (2006) Effectiveness of an influenza vaccine programme for care home staff to prevent death, morbidity, and health service use among residents: cluster randomised controlled trial. BMJ 333(7581):1241
Carman WF et al (2000) Effects of influenza vaccination of health-care workers on mortality of elderly people in long-term care: a randomised controlled trial. Lancet 355(9198):93–97
Potter J et al (1997) Influenza vaccination of health care workers in long-term-care hospitals reduces the mortality of elderly patients. J Infect Dis 175(1):1–6
Babcock HM et al (2009) Mandatory influenza vaccination: translating policy to practice, in Society for Healthcare Epidemiology of America 19th annual scientific meeting. San Diego, CA
Stone PW et al (2009) Staffing and structure of infection prevention and control programs. Am J Infect Control 37(5):351–357
Richards C et al (2001) Characteristics of hospitals and infection control professionals participating in the National Nosocomial Infections Surveillance System 1999. Am J Infect Control 29(6):400–403
Haley RW et al (1980) The SENIC Project. Study on the efficacy of nosocomial infection control (SENIC Project). Summary of study design. Am J Epidemiol 111(5):472–485
O’Boyle C, Jackson M, Henly SJ (2002) Staffing requirements for infection control programs in US health care facilities: Delphi project. Am J Infect Control 30(6):321–333
Horan TC, Andrus M, Dudeck MA (2008) CDC/NHSN surveillance definition of health care-associated infection and criteria for specific types of infections in the acute care setting. Am J Infect Control 36(5):309–332
Edwards JR et al (2008) National Healthcare Safety Network (NHSN) Report, data summary for 2006 through 2007, issued November 2008. Am J Infect Control 36(9):609–626
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2014 Springer International Publishing Switzerland
About this chapter
Cite this chapter
Daniels, T.L., Talbot, T.R. (2014). Infection Control and Prevention Considerations. In: Stosor, V., Zembower, T. (eds) Infectious Complications in Cancer Patients. Cancer Treatment and Research, vol 161. Springer, Cham. https://doi.org/10.1007/978-3-319-04220-6_15
Download citation
DOI: https://doi.org/10.1007/978-3-319-04220-6_15
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-04219-0
Online ISBN: 978-3-319-04220-6
eBook Packages: MedicineMedicine (R0)