Although many of the approximately 9 million health care workers in the United States are employed in hospitals, more and more are serving in nursing homes, outpatient and emergency care clinics, and patients' homes. Any person providing health care can acquire infections from, or transmit infections to, patients, coworkers, household members, and/or other community contacts. Health care providers can also spread infections from patient to patient.

To protect themselves, their patients, and others from infection, health care workers should consistently use Occupational Safety and Health Administration (OSHA)-required and Centers for Disease Control and Prevention (CDC)-recommended infection control strategies. By doing so, they can interrupt the infection process.

Current Challenges
Emerging and Re-emerging Infections
Infections are caused by pathogens (disease-producing microbes) that enter human bodies via various routes. Health care workers' efforts to prevent infections are often hindered by the pace at which they must work and the numbers and kinds of pathogens they encounter. During recent decades, health care workers have been confronted with: (1) many newly recognized pathogens (e.g., hepatitis C and human immunodeficiency viruses), and (2) many re-emerging infections (e.g., those caused by Escherichia coli serotype O157:H7, Bordetella pertussis, group A streptococcus, and Salmonella enterica). This book provides infection control overviews for these infections, as well as many others, including those caused by Bacillus anthracis (a significant challenge to health care workers since 2001) and Clostridium botulinum and variola virus (which have potential for bioterrorist use).

Drug-Resistant Pathogens
The resistance of many pathogens to antimicrobials has created serious therapeutic dilemmas worldwide. Penicillin-resistant Streptococcus pneumoniae poses problems in treating pneumonia and meningitis caused by this bacterium. Vancomycin-resistant enterococci (especially Enterococcus faecalis) also pose problems, and Staphylococcus aureus, already resistant to methicillin, has the potential to become vancomycin-resistant. The resistance of Mycobacterium tuberculosis to drugs traditionally used to treat tuberculosis makes multidrug regimens necessary for infected patients. Some strains of influenza virus type A are now resistant to amantadine and rimantadine. To prevent development of drug-resistant pathogens, clinicians must prescribe antimicrobials appropriately and urge patients to complete their drug regimens.

CDC Guidelines
Despite these many challenges, progress is being made in the fight against infectious diseases. The CDC constantly raises its infection control standards; new guidelines can be downloaded from the www.cdc.gov/ncidod website. Readers should obtain all relevant documents and keep abreast of future updates.

Health care workers should also be familiar with the American Heart Association's current guidelines for prevention of bacterial endocarditis (available at www.americanheart.org).

Health Care Workers' Responsibilities
Health care workers are obligated to eliminate or at least reduce pathogen transmission in their clinical practices, hospitals, and other health care settings and research laboratories. This book reviews the methods necessary to achieve this goal.

Understanding the Cycle of Infection
Health care workers should understand the cycle of infection and how use of appropriate precautions in the workplace can interrupt this cycle. Basic knowledge about the bacteria, protozoans, and viruses encountered in health care settings is vital to fighting infection.

Workers should also know that fungi (e.g., Aspergillus fumigatus, Candida albicans, Coccidioides immitis, Cryptococcus neoformans, and Histoplasma capsulatum) frequently cause infections in immunocompromised patients. Immunocompetent health care workers are not usually at risk of acquiring such infections, but they should use Standard Precautions when caring for patients with fungal infections.

Other precautions include keeping health care facilities dust- and mildew-free and properly disinfected. For example, fungi can be transmitted in air flowing through ventilation systems, nonsterile water used in medical equipment, and dust emanating from surfaces disturbed during repair or construction work. The CDC 2003 guidelines for environmental infection control in health care facilities addresses these problems.

You can order Infection Control & OSHA Essentials, 5th Edition now or read the table of contents, author bio, course objectives or an excerpt from the book to help you decide.