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Cancer Survivor Employs Simple Steps to Fight off Infection During Chemotherapy

Categories: Hand Hygiene, Healthcare-associated infections, Outpatient Care, Patients

Pamela Bryant and family

Pamela Bryant and family

Author: Pamela Bryant, MS
Health Communications Specialist, CDC

To do:

  • Biopsy
  • MRI
  • Port-a-Cath
  • Chemotherapy
  • Genetic Testing
  • Lumpectomy
  • Radiation

The above list is not exactly the type of to-do list I ever thought I’d be faced with. As you can imagine, this list of tests, screenings, procedures, and treatments was a bit overwhelming as I was diagnosed last October with a Stage II breast cancer. Not only did I learn I had triple negative breast cancer, but I had to accept that my treatment plan would definitely include chemotherapy—8 rounds to be exact—followed by surgery and radiation. My life and my family’s life was about to change during this time. So we talked and prayed, and then we prepared for this journey.

As a “CDC-er,” my work as a health communications specialist often involves taking what our team of scientists knows and putting it into easy-to-understand language for the general public. So after I learned that I had cancer and was trying to prepare myself and my family for what was to come, I read about one of chemotherapy’s most serious side effects that I had never heard of before – neutropenia. Almost instantly, my CDC background kicked in. First of all, I thought, “how do you even pronounce this word (new-tro-pee-nee-a, by the way),” and secondly, “how can I explain the seriousness of this to my family?”

Pamela Bryant, MS

Pamela Bryant, MS

Once I did a little digging, I found an excellent resource (right in my back yard!) that explained this condition to my family and me. PreventCancerInfections.org is a web site developed by CDC that provides practical steps that patients and caregivers can take to prevent infections. This website also helps explain what neutropenia is (a low white blood cell count), how and why it makes you more likely to get an infection, and what you and your family can do to help protect yourself.

Ironically, my CDC job involves communicating about basic principles of maintaining good health, such as frequent hand washing and safe food preparation. Fortunately, these practices came naturally for me, but I kicked them into high gear while I was receiving chemotherapy.

One of Chemotherapy’s Most Severe Side Effects: What You Can Do To Prevent An Infection During Treatment For Cancer

Categories: Healthcare-associated infections, Outpatient Care

Michele E. Gaguski MSN RN AOCN CHPN APN-C

Michele E. Gaguski MSN RN AOCN CHPN APN-C

Author: Michele E. Gaguski
MSN RN AOCN CHPN APN-C

As an oncology nurse, I often see anxiety and fear in the eyes of my patients as I  teach them what to expect from their first round of chemotherapy.  Most of the time, patients’ first questions are about the more visible side effects of their treatment:  “Will I lose my hair?” “Will the chemo make me nauseous?”

While all of these are very real and important, none of them may be as life threatening as getting an infection.  Having a low white blood cell count is one of the most serious side effects of chemotherapy.

Here’s how it works:  if you have cancer and are undergoing chemotherapy treatment, the chemotherapy drugs work by killing the cancer cells in your body. However, they also kill the good cells, like your infection-fighting white blood cells.  When this happens and your white blood cell count dips too low, your immune system takes a hit as well, increasing your risk of infection.  This condition, called neutropenia, is common after receiving chemotherapy.

It’s important for patients with cancer to know that getting an infection is an emergency and should be treated as one.  In fact, it’s estimated that each year 60,000 cancer patients are hospitalized for chemotherapy-related infections and one patient dies every two hours from this complication.

Picking a Fight with Multidrug-Resistant Gram-Negative Organisms

Categories: Healthcare-associated infections

Ebbing Lautenbach MD, MPH, MSCE

Ebbing Lautenbach MD, MPH, MSCE

Author: Ebbing Lautenbach MD, MPH, MSCE

Over the last decade, the incidence of multidrug resistance in gram-negative pathogens has steadily increased, yet there has not been any increase in antimicrobial development to address these organisms.  The potential for widespread and rapid transmission of the pathogens is concerning as is the growing prevalence of these organisms in all aspects of patient care – acute care hospitals, long-term acute care hospitals, long-term care and the community .   With their emergence, it has become even more critical to preserve the viability of our current antimicrobials through strong stewardship programs such as those promoted in the recent CDC Vital Signs Report.

Beyond that we need to specifically target Multidrug-Resistant Gram-Negative Organisms or MDROs to create a national and even global response that makes scientific sense to effectively combat this problem.  In the April 2014 special issue of Infection Control and Hospital Epidemiology we published studies that take a critical look at MDROs.  The papers highlighted in this issue provide insights on current practices and raise questions to guide future scientific studies in this research area.   While more research still needs to be done,  these studies help to better define the scope of the problem and understand how different hospitals and healthcare workers approach these organisms including how facilities control the spread of these pathogens.  Applying this research to inform our current practices in order to improve patient outcomes is critical as we wage this battle with MDROs.

Yet with so many areas of Healthcare Associated Infections (HAIs) being interdependent it is impossible to address the issue of MDROs without pairing it with overall good HAI prevention such as antimicrobial stewardship, environmental cleaning, hand hygiene, and more.    It is also careless to only consider this problem in the acute care setting, as the frequent transfer of patients between different healthcare facilities is a crucial element of the problem.  As a healthcare system, we need to promote and develop evidence-based interventions for MDROs and other supplemental infection prevention interventions to defeat MDROs while saving lives and decreasing healthcare costs overall.

Despite Progress, three-quarters of a million infections threaten hospital patients each year

Categories: Antimicrobial Resistance, BSIs, CAUTI, CLABSI, Clostridium difficile, Healthcare-associated infections, Long Term Care (LTC), NHSN, State HAI Prevention

National and State Healthcare-associated Infections Progress Report. This report is based on 2012 data, Published March 2014

National and State Healthcare-associated Infections Progress Report. This report is based on 2012 data, Published March 2014

Despite Progress, three-quarters of a million infections threaten hospital patients each year
National and state data detail threat of healthcare-associated infections and opportunities for further improvements.

CDC released two reports today – one, a New England Journal of Medicine (NEJM) article detailing national healthcare-associated infection estimates, and the other an annual report on national and state-specific progress toward U.S. Health and Human Services HAI prevention goals. Together, the reports show that progress has been made in the effort to eliminate infections that commonly threaten hospital patients, but more work is needed to improve patient safety.

The NEJM article updates the burden numbers for healthcare-associated infections in hospitals.  On any given day, 1 of every 25 patients had 1 or more infections related to their hospital stay.   That means about 722,000 infections a year related to medical care.  One of every 9 patients who gets an infection will die during their hospitalization.

This article sounds the alarm about threats we need to address now.  It tells us that lung infections, gut infections, surgical infections and infection from urinary catheters are harming the most patients.

Some of the top pathogens attacking patients are: 

  • C. difficile, or deadly diarrhea,
  • Staph, including the drug-resistant type known as MRSA,
  • a family of germs known as Enterobacteriaceae, that includes CRE the “nightmare bacteria,”

The second report, CDC’s National and State Healthcare-associated Infection Progress Report, includes national and state-by-state summaries of infection types that are commonly required to be reported to CDC. The Progress Report looked at data submitted to CDC’s National Healthcare Safety Network (NHSN), the nation’s healthcare-associated infection tracking system.   On the national level, the report found a:

  • 44 percent decrease in central line-associated bloodstream infections between 2008 and 2012
  • 20 percent decrease in infections related to the 10 surgical procedures tracked in the report between 2008 and 2012
  • 4 percent decrease in hospital-onset MRSA bloodstream infections between 2011 and 2012
  • 2 percent decrease in hospital-onset C. difficile infections between 2011 and 2012
  • 3 percent increase in catheter-associated urinary tract infections

At the federal and state levels, CDC uses this information to find facilities that need help and target resources where they are most needed.

To access both reports and to see the updated healthcare-associated infection data, see CDC’s website: www.cdc.gov/hai.

Watch a new video on Healthcare-Associated Infections.

C. diff in Our Kids: A Call to Action

Categories: Clostridium difficile, Healthcare-associated infections

Peggy Lillis was the mother of two and a Brooklyn kindergarten teacher.  Peggy lost her battle to C. difficile infection in 2010.  She had only been ill for 6 days.  Learn more about Peggy’s story: http://www.peggyfoundation.org/

Peggy Lillis was the mother of two and a Brooklyn kindergarten teacher. Peggy lost her battle to C. difficile infection in 2010. She had only been ill for 6 days. Learn more about Peggy’s story: http://www.peggyfoundation.org/

Author: Christian John Lillis

My mother loved children. Me and my brother Liam, her 12 godchildren, and the 24 children she taught each year in her kindergarten class. We lost Mom at just 56 years old to a Clostridium difficile infection in April 2010. In response to her death, we started the Peggy Lillis Foundation to raise C. diff awareness.

That is why we are both distressed and pleased by the Centers for Disease Control and Prevention’s new paper on C. diff infections in children. Distressed that so many children are suffering but pleased that the paper explodes a piece of C. diff mythology that persists in our healthcare system, where even some physicians cling to a dangerous notion that children don’t get C. diff.

The CDC finding that 17,000 children contract the disease each year, most outside of healthcare settings, is a call to action for healthcare providers. Clinicians should consider whether symptoms such as fever, loss of appetite, cramping, and painful diarrhea might be indications of C. diff. When prescribing antibiotics to kids, they should ask themselves whether the drug is absolutely necessary, since antibiotic exposure is a key risk factor for C. diff.

This report also alerts parents to ask doctors whether symptoms they can plainly see are severe and out of the ordinary might be signs of a C. diff infection, especially if their child has recently taken an antibiotic. In the presence of such symptoms, especially when initial treatments don’t work, parents should ask about a stool test.

In 2013, the CDC declared C. diff. an "urgent" public-health threat, placing it first on the list of critical dangers to Americans. But many reports of C. diff focus on adults and seniors in long-term care settings, leading to ignorance of its risks to younger patients.

Angela G., a Brooklyn mother, found this out the hard way when her kids were five and two. Spotting symptoms like fever and diarrhea, she took them to a pediatrician who insisted they had a stomach flu. After escalating symptoms, repeated visits, and finally a trip to the emergency room, a test resulted in the proper diagnosis: C. diff.

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