"Embargoed until Monday, February 28, 2005 at 12:30 pm."Since 2002, 4 states have enacted legislation that requires health care organizations to publicly disclose health care-associated infection (HAI) rates. Similar legislative efforts are underway in several other states. Advocates of mandatory public reporting of HAIs believe that making such information publicly available will enable consumers to make more informed choices about their health care and improve overall health care quality by reducing HAIs. Further, they believe that patients have a right to know this information. However, others have expressed concern that the reliability of public reporting systems may be compromised by institutional variability in the definitions used for HAIs, or in the methods and resources used to identify HAIs. Presently, there is insufficient evidence on the merits and limitations of an HAI public reporting system. Therefore, the Healthcare Infection Control Practices Advisory Committee (HICPAC) has not recommended for or against mandatory public reporting of HAI rates. However, HICPAC has developed this guidance document based on established principles for public health and HAI reporting systems. This document is intended to assist policymakers, program planners, consumer advocacy organizations, and others tasked with designing and implementing public reporting systems for HAIs. The document provides a framework for legislators, but does not provide model legislation. HICPAC recommends that persons who design and implement such systems 1) use established public health surveillance methods when designing and implementing mandatory HAI reporting systems; 2) create multidisciplinary advisory panels, including persons with expertise in the prevention and control of HAIs, to monitor the planning and oversight of HAI public reporting systems; 3) choose appropriate process and outcome measures based on facility type and phase in measures to allow time for facilities to adapt and to permit ongoing evaluation of data validity; and 4) provide regular and confidential feedback of performance data to healthcare providers. Specifically, HICPAC recommends that states establishing public reporting systems for HAIs select one or more of the following process or outcome measures as appropriate for hospitals or long-term care facilities in their jurisdictions: 1) central-line insertion practices; 2) surgical antimicrobial prophylaxis; 3) influenza vaccination coverage among patients and healthcare personnel; 4) central line-associated bloodstream infections; and 5) surgical site infections following selected operations. HICPAC will update these recommendations as more research and experience become available.Also published as: McKibben L, Horan T, Tokars JI, Fowler G, Cardo DM, Pearson ML, Brennan PJ. Guidance on public reporting of healthcare-associated infections: recommendations of the healthcare infection control practices advisory committee. Infect Control Hosp Epidemiol. 2005 Jun;26(6):580-7.Includes bibliographical references (p. 28-30).1587701

The Middle East respiratory syndrome (MERS) outbreak in Korea in 2015 may be attributable to poor nosocomial infection control procedures implemented. Strict infection control measures were taken in the hospital where an imported case with MERS was treated in southern China and 53 health care workers were confirmed to be MERS-CoV negative. Infection control in healthcare settings, in which patients with emerging infectious diseases such as MERS, Ebola virus disease, and the severe acute respiratory syndrome (SARS) are diagnosed and treated, are often imperfect. When it comes to emerging or unknown infectious diseases, before the imported case was finally identified or community transmission was reported, cases have often occurred in clusters in healthcare settings. Nosocomial infection control measures should be further strengthened among the workers and inpatients in designated healthcare settings that accommodate suspected cases suffering from emerging or unknown infectious diseases.

HICPAC November 2, 2023Disclaimer: The findings and conclusions herein are draft and have not been formally disseminated by the Centers for Disease Control and Prevention and should not be construed to represent any agency determination or policy.Publication date from document properties.HCP-Workgroup-HICPAC-2023-11-2-508.pd

Healthcare-associated infections (HAIs), previously known as nosocomial infections, represent a significant threat to healthcare systems worldwide, prolonging patient hospital stays and the duration of antimicrobial therapy. One of the most serious consequences of HAIs is the increase in the rate of antibiotic resistance (AR) generated by the prolonged, frequent, and sometimes incorrect use of antibiotics, which leads to the selection of resistant bacteria, making treatment difficult and expensive, with direct consequences for the safety of patients and healthcare personnel. Therefore, timely and accurate diagnosis of HAIs is mandatory to develop appropriate infection prevention and control practices (IPC) and new therapeutic strategies. This review aimed to present the prevalence, risk factors, current diagnosis, including artificial intelligence (AI) and machine learning approaches, future perspectives in combating HAIs causative bacteria (phage therapy, microbiome-based interventions, and vaccination), and HAIs surveillance strategies. Also, we discussed the latest findings regarding the relationships of AR with climate change and environmental pollution in the context of the One Health approach. Phage therapy is an emerging option that can offer an alternative to ineffective antibiotic treatments for antibiotic-resistant bacteria causing HAIs. Clinical trials dealing with vaccine development for resistant bacteria have yielded conflicting results. Two promising strategies, fecal microbiota transplantation and probiotic therapy, proved highly effective against recurrent Clostridium difficile infections and have been shown to reduce HAI incidence in hospitalized patients undergoing antibiotic therapy. Artificial intelligence and machine learning systems offer promising predictive capabilities in processing large volumes of clinical, microbiological, and patient data but require robust data integration. Our paper argues that HAIs are still a global challenge, requiring stringent IPC policies, computer vision, and AI-powered tools. Despite promising avenues like integrated One Health approaches, optimized phage therapy, microbiome-based interventions, and targeted vaccine development, several knowledge gaps in clinical efficacy, standardization, and pathogen complexity remain to be answered.

The Department of Health and Human Services (HHS) and the Centers for Disease Control and Prevention (CDC) Division of Healthcare Quality Promotion (DHQP) convened a meeting of the Healthcare Infection Control Practices Advisory Committee (HICPAC) on November 12-13, 2009 in Washington, DC. None of the HICPAC voting members declared any new conflicts of interest for the record that were pertinent to the published agenda for the November 12-13, 2009 meeting.Publication date from document properties.2009-November-HICPAC-meeting.pd

The US Department of Health and Human Services (HHS) and the Centers for Disease Control and Prevention (CDC) National Center for Emerging and Zoonotic Infectious Diseases (NCEZID) Division of Healthcare Quality Promotion (DHQP) convened a meeting of the Healthcare Infection Control Practices Advisory Committee (HICPAC) on July 13-14, 2017 in Atlanta, Georgia. The Designated Federal Official (DFO) and Chair confirmed the presence of a quorum of HICPAC voting members and ex officio members, which was maintained throughout each day.Publication date from document properties.2017-July-HICPAC-meeting.pdf201

The United States (US) Department of Health and Human Services (HHS) and the Centers for Disease Control and Prevention (CDC) National Center for Emerging and Zoonotic Infectious Diseases (NCEZID) Division of Healthcare Quality Promotion (DHQP) convened a meeting of the Healthcare Infection Control Practices Advisory Committee (HICPAC) on May 17-18, 2018 in Atlanta, Georgia. The Designated Federal Official (DFO) and co-Chairs confirmed the presence of a quorum of HICPAC voting members and ex officio members, which was maintained throughout the meeting.Publication date from document properties.2018-May-HICPAC-Summary-508.pdf201

The US Department of Health and Human Services (HHS) and the Centers for Disease Control and Prevention (CDC) National Center for Emerging and Zoonotic Infectious Diseases (NCEZID) Division of Healthcare Quality Promotion (DHQP) convened a meeting of the Healthcare Infection Control Practices Advisory Committee (HICPAC) on November 8-9, 2017, in Atlanta, Georgia. The Designated Federal Official (DFO) and Chair confirmed the presence of a quorum of HICPAC voting members and ex officio members, which was maintained throughout each day.Publication date from document properties.2017-November-HICPAC-Meeting-508.pdf201

Effective implementation of infection prevention and control in healthcare facilities depends on training, awareness and compliance of healthcare workers. In Saudi Arabia recent significant hospital outbreaks, including Middle East Respiratory Syndrome Coronavirus (MERS-CoV), have resulted from lack of, or breakdown in, infection prevention and control procedures. This study was designed to assess attitudes to, and awareness of, infection prevention and control policies and guidelines among healthcare workers of different professions and institution types in Saudi Arabia. A questionnaire was administered to 607 healthcare workers including physicians (n = 133), nurses (n = 162), laboratory staff (n = 233) and other staff (n = 79) in government hospitals, private hospitals and poly clinics. Results were compared using Chi square analysis according to profession type, institution type, age group and nationality (Saudi or non-Saudi) to assess variability. Responses suggested that there are relatively high levels of uncertainty among healthcare workers across a range of infection prevention and control issues, including institution-specific issues, surveillance and reporting standards, and readiness and competence to implement policies and respond to outbreaks. There was evidence to suggest that staff in private hospitals and nurses were more confident than other staff types. Carelessness of healthcare workers was the top-cited factor contributing to causes of outbreaks (65.07% of total group), and hospital infrastructure and design was the top-cited factor contributing to spread of infection in the hospital (54.20%), followed closely by lack and shortage of staff (53.71%) and no infection control training program (51.73%). An electronic surveillance system was considered the most effective by staff (81.22%). We have identified areas of concern among healthcare workers in Saudi Arabia on infection prevention and control which vary between institutions and among different professions. This merits urgent multi-factorial actions to try to ensure outbreaks such as MERS-CoV can be minimized and contained.

The US Department of Health and Human Services (HHS) and the Centers for Disease Control and Prevention (CDC) National Center for Emerging and Zoonotic Infectious Diseases (NCEZID) Division of Healthcare Quality Promotion (DHQP) convened a teleconference meeting of the Healthcare Infection Control Practices Advisory Committee (HICPAC) on February 15, 2018. The Designated Federal Official (DFO) and co-Chairs confirmed the presence of a quorum of HICPAC voting members and ex officio members, which was maintained throughout the meetingPublication date from document properties.2018-February-HICPAC-Transcript-P.pdf201

Background Infection prevention and control (IPC) safety culture is recognized as a crucial factor in improving healthcare workers’ (HCWs) compliance with IPC measures. Despite its importance, evidence regarding the influence of IPC safety culture on compliance remains limited and warrants further investigation. Methods A cross-sectional study was conducted from March 27 to April 3, 2025, using an online questionnaire to examine the association between IPC safety culture and HCWs’ compliance with IPC measures across more than 200 healthcare institutions, including 12 tertiary hospitals, in Haizhu District, Guangzhou, Guangdong Province, China. IPC safety culture was assessed using the Infection Control Culture Scale, while compliance with IPC measures was measured with the Compliance with Standard Precautions Scale, both utilizing five-point Likert scales. Student’s t test assessed differences between groups, and linear correlation analyses examined relationships between IPC safety culture dimensions and compliance scores. Multivariate logistic regression was used to identify factors associated with HCWs’ compliance to IP measures. Results A total of 1,600 questionnaires were distributed, of which 1,471 were valid (91.94%). HCWs aged over 30 years, with more than 5 years of work experience, and holding a Master’s degree or higher had higher IPC safety culture scores compared with their counterparts (p < 0.05). Similarly, HCWs aged over 30 years, with more than 5 years of experience, a Master’s degree or higher, and possessing clinical teaching qualifications demonstrated higher compliance with IPC measures compared with their counterparts (p < 0.05). Linear correlation analysis showed that basic IPC competence was strongly correlated with all dimensions of IPC compliance (r = 0.70, 0.63, 0.62, 0.63, 0.64, and 0.58, p < 0.001). Hospital management climate, departmental team cooperation, organizational learning and continuous improvement, and reporting frequency of hospital-acquired infections (HAIs) adverse events were weakly to moderately correlated with IPC compliance (p < 0.001). Based on a median score of 4.95 (IQR 4.77–5.00), 840 participants (57.10%) were classified as having good compliance, and 631 (42.90%) as poor compliance. Multivariate logistic regression indicated that clinical instructor status (OR = 1.60, 95% CI: 1.46–1.79), basic IPC competence (OR = 1.87, 95% CI: 1.73–1.99), hospital management climate (OR = 1.50, 95% CI: 1.08–2.10), reporting frequency of HAIs adverse events (OR = 1.36, 95% CI: 1.19–1.54), and organizational learning and continuous improvement (OR = 3.59, 95% CI: 2.68–4.80) as independent predictors of IPC compliance. Conclusion IPC safety culture significantly affects HCWs’ adherence to IPC measures. Enhancing basic IPC competence, hospital management support, organizational learning, reporting practices, and targeted interventions for clinical instructors can improve compliance and help prevent HAIs.

The US Department of Health and Human Services (HHS) and the Centers for Disease Control and Prevention (CDC) National Center for Emerging and Zoonotic Infectious Diseases (NCEZID) Division of Healthcare Quality Promotion (DHQP) convened a teleconference meeting of the Healthcare Infection Control Practices Advisory Committee (HICPAC) on August 29, 2018. The Designated Federal Official (DFO) and co-Chairs confirmed the presence of a quorum of HICPAC voting members and ex officio members, which was maintained throughout the meeting.Publication date from document properties.2018-August-HICPAC-Transcript-508.pdf201

In Japan, the practice of infection control in healthcare settings has a short history of less than 3 decades. Before that, infection control practices were far from perfect and even ignored. This review summarizes changes in infection control in Japan since the 1980s and offers some comparisons with practices in foreign countries, especially the United States. Infection control is far better now than 25 years ago, but there remain fundamental issues that limit the development of better infection control practices. These problems include insufficient funding and human resources due to the socialized healthcare insurance system in Japan and the lack of interest in infection control research.

The United States (US) Department of Health and Human Services (HHS) and the Centers for Disease Control and Prevention (CDC) National Center for Emerging and Zoonotic Infectious Diseases (NCEZID) Division of Healthcare Quality Promotion (DHQP) convened a meeting of the Healthcare Infection Control Practices Advisory Committee (HICPAC) on November 15-16, 2018 in Atlanta, Georgia. The presence of a quorum of HICPAC voting members and ex officio members was confirmed and maintained throughout each day of the meeting.The meeting was called to order at 9:15 am on November 15, 2018. Dr. Denise Cardo provided an update on current DHQP activities. Dr. Vineet Chopra and Ms. Erin Stone presented an update from the HICPAC Product and Practices Workgroup, presenting a draft tool for HICPAC to use when formulating recommendations for products and a \u201cpilot test\u201d of the draft tool.Publication date from document properties.2019615

Summary Background Increased risk of healthcare-associated infections (HAIs) in radiology departments has been reported in recent years. Optimal infection control practices (ICPs) are the key to controlling HAIs, but few studies have investigated the ICP compliance of healthcare workers (HCWs) in radiology departments. Aim To assess the level of ICP compliance of HCWs in a radiology department. Methods A participant observation supplemented with adenosine triphosphate (ATP) bioluminescence assay evaluation of environmental cleanliness was conducted. More than 1000 hand hygiene (HH) opportunities and 960 opportunities for the other core ICP elements were observed in different study units of a radiology department. An online checklist powered by eRub was used to record the HCWs' ICP performance. A total of 125 environmental samples were collected for ATP assay evaluation. Results In the participants observation, the overall performance score was 41.4%. The lowest score was found in HH (10.4%), followed by use of personal protective equipment (29.4%) and gloves (68.2%). The HH performance was significantly associated with study units (χ2 = 42.55, P < 0.001), professional groups (χ2 = 110.21, P < 0.001), and patient-to-staff ratio (F = 8.76, P < 0.001). With relative light units of ≤250 set as a pass benchmark, less than two-thirds of the environmental samples passed the ATP assay. Conclusion The overall ICP compliance among the HCWs in the radiology department was suboptimal. Revisions of current ICP guidelines and policies that are tailored to the setting-specific needs and barriers in radiology departments is necessary.

The Guideline for Hand Hygiene in Health-Care Settings provides health-care workers (HCWs) with a review of data regarding handwashing and hand antisepsis in health-care settings. In addition, it provides specific recommendations to promote improved hand-hygiene practices and reduce transmission of pathogenic microorganisms to patients and personnel in health-care settings. This report reviews studies published since the 1985 CDC guideline (Garner JS, Favero MS. CDC guideline for handwashing and hospital environmental control, 1985. Infect Control 1986;7:231-43) and the 1995 APIC guideline (Larson EL, APIC Guidelines Committee. APIC guideline for handwashing and hand antisepsis in health care settings. Am J Infect Control 1995;23:251-69) were issued and provides an in-depth review of hand-hygiene practices of HCWs, levels of adherence of personnel to recommended handwashing practices, and factors adversely affecting adherence. New studies of the in vivo efficacy of alcohol-based hand rubs and the low incidence of dermatitis associated with their use are reviewed. Recent studies demonstrating the value of multidisciplinary hand-hygiene promotion programs and the potential role of alcohol-based hand rubs in improving hand-hygiene practices are summarized. Recommendations concerning related issues (e.g., the use of surgical hand antiseptics, hand lotions or creams, and wearing of artificial fingernails) are also included.prepared by John M. Boyce, Didier Pittet."October 25, 2002.""The material in this report originated in the National Center for Infectious Diseases, James M. Hughes, M.D., Director; and the Division of Healthcare Quality Promotion, Steve Solomon, M.D., Acting Director." - p. 1Published also as: American journal of infection control, v. 30, no. 8, suppl 1; and in: Infection control and hospital epidemiology, v. 23, no. 12, suppl.Title from title.Includes bibliographical references (p. 34-44)