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Books > Medicine > Clinical & internal medicine > Paediatric medicine
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Healthcare-Associated Infections in Children - A Guide to Prevention and Management (Paperback, 1st ed. 2019)
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Healthcare-Associated Infections in Children - A Guide to Prevention and Management (Paperback, 1st ed. 2019)
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With advances in technology and medical science, children with
previously untreatable and often fatal conditions, such as
congenital heart disease, extreme prematurity and pediatric
malignancy, are living longer. While this is a tremendous
achievement, pediatric providers are now more commonly facing
challenges in these medical complex children both as a consequence
of their underlying disease and the delivery of medical care. The
term healthcare-associated infections (HAIs) encompass both
infections that occur in the hospital and those that occur as a
consequence of healthcare exposure and medical complexity in the
outpatient setting. HAIs are associated with substantial morbidity
and mortality for the individual patient as well as seriously
taxing the healthcare system as a whole. In studies from the early
2000s, over 11% of all children in pediatric intensive care units
develop HAIs and this figure increases substantially if neonatal
intensive care units are considered. While progress has been made
in decreasing the rates of HAI in the hospital, these infections
remain a major burden on the medical system. In a study published
in 2013, the annual estimated costs of the five most common HAIs in
the United States totaled $9.8 billion. An estimated 648,000
patients developed HAIs in hospitals within the US in 2011 and
children with healthcare-associated bloodstream infection have a
greater than three-fold increased risk of death.While a number of
texts discuss HAIs in the broader context of infectious diseases or
pediatric infectious diseases (such as Mandell's Principles and
Practice of Infectious Diseases or Long and Pickering's Principles
and Practice of Pediatric Infectious Diseases) no single text
specifically focuses on the epidemiology, diagnosis and management
of HAI in children. Many infectious diseases texts are organized
based on the microbiology of infection and from this starting point
then discussing the clinical syndromes associated with the organism
of interest. For instance, a chapter on Staphylococcus aureus may
contain a brief discussion of the role of S. aureus in surgical
site infections in the wider context of all staphylococcal disease.
For clinicians caring for children at the bedside, however, the
clinical syndrome is typically appreciated and intervention
necessary prior to organism identification. We propose a text that
details both the general principles involved in HAIs and infection
prevention but also provides a problem oriented approach. Such a
text would be of interest to intensivists, neonatologists,
hospitalists, oncologists, infection preventionists and infectious
diseases specialists. The proposed text will be divided into three
principle sections: 1) Basic Principles of Infection Control and
Prevention, 2) Major Infectious Syndromes and 3) Infections in
Vulnerable Hosts. Chapters in the Major Infectious Syndromes
section will include discussion of the epidemiology, microbiology,
clinical features, diagnosis, medical management (or surgical
management as appropriate) and prevention of the disease entity of
interest. Chapters will seek to be evidenced based as much as
possible drawing from the published medical literature as well as
from clinical practice guidelines (such as those from the
Infectious Diseases Society of America) when applicable. We intend
to include tables, figures and algorithms as appropriate to assist
clinicians in the evaluation and management of these often complex
patients. Finally, we intend to invite authors to participate in
this project from across a number of medical specialties including
infectious diseases, infection control, critical care, oncology and
surgery to provide a multidisciplinary understanding of disease. It
is our intent to have many chapters be co-written by individuals in
different subspecialties; for instance, a chapter on
ventilator-associated pneumonia may be co-written by both
infectious disease and critical care medicine specialists. Such a
unique text has the potential to provide important guidance for
clinicians caring for these often fragile children.
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