Chapter 125. Health Care– Associated Infections (Part 1) Harrison's Internal Medicine > Chapter 125. Health Care–Associated Infections Health Care–Associated Infections: Introduction The costs of hospital-acquired (nosocomial) and other health care– associated infections are great. It is estimated that these infections affect >2 million patients, cost $4.5 billion, and contribute to 88,000 deaths in U.S. hospitals annually. Efforts to lower infection risks have been challenged by the growing numbers of immunocompromised patients, antibiotic-resistant bacteria, fungal and viral superinfections, and invasive devices and procedures. Nevertheless, evidence-based guidelines for prevention and control are available (Table 125-1); according to some estimates, consistent application of these guidelines may reduce the risk of health care–associated infection by more than one-third, and the growing viewpoint of consumer advocates is that almost all such infections are preventable. This chapter reviews health care–acquired and device-related infections and the basic surveillance, prevention, control, and treatment activities that have been developed to deal with these problems. Table 125-1 Sources of Infection-Control Guidance and Oversight Orga nization Role Major Constituents Web Site JCAH O Regu latory Hospitals, long-term-care facilities, laboratories http://www.jcaho.org CAP Regu latory Laborator ies http://www.cap.org OSH Regu Workers http://www.osha.gov A latory CMS (formerly HCFA) Regu latory Medicare /Medicaid providers http://www.cms.hhs.gov CDC DH QP Advi sory Health care facilities and personnel http://www.cdc.gov/ncidod/dhq p/index.html HIC PAC Advi sory Health care facilities and personnel http://www.cdc.gov/ncidod/dhq p/hicpac_charter.html NIO SH Advi sory Workers http://www.cdc.gov/niosh/ AHR Q Advi sory Broad (e.g., health care http://www.ahrq.org personnel) NQF Advi sory Broad (e.g., health care personnel) http://www.qualityforum.org IOM Advi sory Broad (e.g., health care personnel) http://www.iom.edu IDSA Profe ssional society Infectious disease physicians/resea rchers http://www.idsociety.org SHEA Profe ssional society Hospital epidemiologists http://www.shea-online.org APIC Profe ssional Infection- control http://www.apic.org society practitioners MedQ IC Qual ity improveme nt Broad (e.g., health care personnel) http://www.medqic.org IHI Qual ity improveme nt Broad (e.g., health care personnel) http://www.ihi.org . Chapter 125. Health Care– Associated Infections (Part 1) Harrison's Internal Medicine > Chapter 125. Health Care Associated Infections Health Care Associated Infections: . of health care associated infection by more than one-third, and the growing viewpoint of consumer advocates is that almost all such infections are preventable. This chapter reviews health care–acquired. Introduction The costs of hospital-acquired (nosocomial) and other health care– associated infections are great. It is estimated that these infections affect >2 million patients, cost $4.5 billion,