Compendium 2022 Update: Strategies for Healthcare-associated Infection Prevention

Posted on by Lisa Maragakis, M.D., M.P.H., FSHEA, FIDSA and Deborah Yokoe, MD, MPH
Dr. Lisa Maragakis and Dr. Deborah Yokoe
Dr. Lisa Maragakis and Dr. Deborah Yokoe

Updated recommendations on how to prevent central line-associated bloodstream infections (CLABSIs), as well as ventilator-associated pneumonia, ventilator-associated events (VAEs), and non-ventilator healthcare-associated pneumonia (NV-HAP) were recently published. These changes come at a time when the need to strengthen infection prevention programs and help hospitals rebuild and support healthcare systems is urgent. These two guidance documents are the first of seven that will be released throughout 2022 as a part of the updates to the infection prevention resource: SHEA/IDSA/APIC Compendium of Strategies to Prevent Healthcare-Associated Infections in Acute Care Hospitals. The Compendium, as it is commonly known, provides practical recommendations for preventing healthcare associated infections (HAIs) that have major impacts on the quality and safety of patient care.

First published in 2008 and updated in 2014, the third release of this nationally and globally utilized resource continues to provide up-to-date, concise, and practical recommendations for essential infection prevention practices and guidance on how to build them into the delivery of care.

After two decades of declining HAI rates, the COVID-19 pandemic made it extremely difficult for healthcare systems to maintain their HAI prevention efforts. These challenges lead to extensive increases in some HAIs despite the extraordinary dedication and tireless efforts of infection prevention specialists, healthcare epidemiologists, and antimicrobial stewards.1,2

The 2022 update has a new article dedicated to the use of implementation strategies to put HAI prevention recommendations into practice. These articles also include implementation guidance for the prevention of specific HAIs. These resources pair well with CDC guidelines and help make infection prevention efforts better. The Compendium is the product of a partnership among several organizations focused on infection prevention and quality improvement. It is led by the Society for Healthcare Epidemiology of America (SHEA) and developed with the Infectious Diseases Society of America (IDSA), the Association for Professionals in Infection Control and Epidemiology (APIC), the American Hospital Association (AHA), and The Joint Commission, with major contributions from representatives of organizations and societies, including the Centers for Disease Control and Prevention (CDC), the Pediatric Infectious Disease Society (PIDS), and the Surgical Infection Society (SIS).

Compendium recommendations are developed from scientific research findings, evaluations, expert consensus, as well as practical and implementation-based considerations. It divides recommendations into “essential practices” that should be adopted by all acute care hospitals, and “additional approaches” that can be considered for use the essential practices are not as effective as needed.

The Compendium can be used to expand and reinforce multidisciplinary and organizational efforts to build stronger HAI prevention infrastructures that address system weaknesses (like those highlighted during the COVID-19 pandemic) and are evidence-based, sustainable, and resilient. Epidemics, pandemics, and other disruptions in healthcare delivery will continue to exist in the future and patients will count on our delivery of safe, high-quality, and high-value care. The Compendium: 2022 updates will be an essential resource to strengthen HAI prevention programs and build better, safer healthcare systems.

  1. Weiner-Lastinger LM, et al. The impact of coronavirus disease 2019 (COVID-19) on healthcare-associated infections in 2020: A summary of data reported to the National Healthcare Safety Network. Infect Control Hosp Epidemiol 2022; 43:12-25.
  2. Fleisher LA, et al. Health care safety during the pandemic and beyond—building a system that ensures resilience. New Engl J of Med 2022; 386:609-611


Lisa Maragakis, M.D., M.P.H., FSHEA, FIDSA is a professor of medicine and epidemiology at Johns Hopkins University School of Medicine and the Johns Hopkins Bloomberg School of Public Health. Dr. Maragakis is the Senior Director of Infection Prevention, for The Johns Hopkins Health System and the Hospital Epidemiologist for The Johns Hopkins Hospital. In these roles, she is responsible for the conceptualization, planning, implementation, and development of the Johns Hopkins Health System’s infection control and prevention program. Her research interests are the epidemiology, prevention and control of healthcare-acquired infections and antimicrobial-resistant gram-negative bacilli. Dr. Maragakis serves as the Executive Director of the Johns Hopkins Hospital Biocontainment Unit and as Incident Commander for the Johns Hopkins Medicine COVID-19 response.  She also serves as the IDSA Co-Chair for the Update of the Compendium of Strategies to Prevent Healthcare-Associated Infections, and as Co-Chair of the Centers for Disease Control and Prevention’s Healthcare Infection Control Practices Advisory Committee (HICPAC).

Dr. Deborah Yokoe is a Professor of Clinical Medicine in the Division of Infectious Diseases, Department of Medicine at University of California, San Francisco. She is the Medical Director for Hospital Epidemiology and Infection Prevention for the adult services and an attending physician on the Transplant Infectious Diseases consultation service.  She has served as the co-chair of the U.S. Department of Health and Human Services’ Healthcare Infection Control Practices Advisory Committee (HICPAC) which advises the Centers for Disease Control and Prevention on infection prevention and control issues and serves as the SHEA Co-Chair for the Update of the Compendium of Strategies to Prevent Healthcare-Associated Infections. She is also a member of the Society for Healthcare Epidemiology of America (SHEA) Board of Trustees, currently serving as SHEA President-Elect.

Posted on by Lisa Maragakis, M.D., M.P.H., FSHEA, FIDSA and Deborah Yokoe, MD, MPHTags , ,

16 comments on “Compendium 2022 Update: Strategies for Healthcare-associated Infection Prevention”

Comments listed below are posted by individuals not associated with CDC, unless otherwise stated. These comments do not represent the official views of CDC, and CDC does not guarantee that any information posted by individuals on this site is correct, and disclaims any liability for any loss or damage resulting from reliance on any such information. Read more about our comment policy ».

    Health care-associated infections (HAIs) are caused by bacteria, viruses, and fungi. Most of these diseases can be contracted anywhere, but they become more of a problem in healthcare settings. Most HCAIs are caused by bacteria already present in the patient’s body prior to infection and may cause cross-transmission between patients or between patients and healthcare workers. The environment of a healthcare facility can also be a source of infection, with the spread of microorganisms through air, water or surfaces.

    I am a urologist in Houston with interest in eradicating and preventing CAUTI [catheter associated urinary tract infections]. CAUTI is basically caused by microbe induced biofilm that enshrouds and protects surfaces [urothelial and prosthetic] attached microbes from the killing effects of planktonic antibiotics.

    Witch Hazel [WH] concentrate is an FDA certified/Over-the-counter [OTC[ botanical that prevents and erodes biofilm; it is largely unknown to the Infectious Disease world.

    We have bench tested and have patent pending for mixture of WH with mother nature’s elements [metals, halogens and oxygen]. This multi-agent mixture is a more potent [at higher dilutions] ‘antimicrobial’ than any disinfectant [such as Betadine] co- studied, todate. Potential collaborative investigators are invited to contact me.

    For the last ten years, I and a group of noted physician/researchers have been investigating the potential to reduce HAI, improve microbiome diversity and diminish antibiotic use (in all mammals) through the deployment of iodine (as PVP-I) in an adjunctive fashion. We are available to discuss this with anyone interested, and we suspect that we can help significantly to LOWER COSTS and REDUCE HAIs through the judicious adjunctive use of PVP-I, in appropriate concentrations, mixtures and application timing. The efficacy of this marvelously inexpensive product is backed by 200 years of broad-base, continuous use in medicine with zero incidence of AMR and a superior level of antisepsis. The waning iodine sufficiency of our population is also to be considered, along with that insufficiency’s impact of maternal, fetal, adolescent and geriatric health. Iodine’s potential for mitigating all viral species is well-explored, and is legendary (goes back to Sir F.M. Burnet’s experiments with H1N1 in 1945).

    CHG bathing is extremely harmful and destroys skin integrity and the skins microbiome. Baffling clinical determination to promote a HIGH recommendation for CHG bathing for CLABSI. Understanding the Stratum Corneum and Skin pH must not be part of the clinical process. CHG increases the skins susceptability to pathogens and breakdown by killing all cells. CHG is great for Presurgical prep but ridiculous to recommend as a bathing product. I feel sorry for the Skin and Wound Team in hospitals that follow this recommendation. Looks like the money behind CHG continues to drive clinical decisions to the detriment of the patient.

    Prevention starts at home effects of cleaning fields,disease trees, dead animals, pesticides,sidewalk cleaning cleaning, stop larvae growing water ways will help the whole ecological process and sustainable vegetables and jobs

    Pueden enviar los textos de estas guías en español??
    Muchas gracias
    Rosa Guzman

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Page last reviewed: June 30, 2022
Page last updated: June 30, 2022