Acknowledgments EDITORS AUTHORS. Clinical Editor. Section Editors

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1 Acknowledgments The acknowledges the valuable contributions from each of the following individuals: EDITORS Clinical Editor Patti Grota, PhD, RN, CNS-M-S, CIC Assistant Professor Schreiner University Kerrville, TX Section Editors Vicki Allen, MSN, RN, CIC Infection Control Manager CaroMont Health Gastonia, NC Kelley M. Boston, MPH, CIC Director of Accreditation and Regulatory Compliance Regional Director San Antonio Infection Prevention & Management Associates, Inc. Amelia C. Bumsted, BA, BS, RN, CRRN, CIC Wheaton Franciscan Health System Marianjoy Rehabilitation Hospital Wheaton, IL Laurie J. Conway RN, MPhil, CIC Columbia University School of Nursing New York, NY Lynn Slonim Fine PhD, MPH, CIC Infection Prevention Program University of Rochester Medical Center Rochester, NY Christopher E. Florez, MPH, CIC Program Director, EPIC Course 383rd Training Squadron Joint Base Fort Sam Houston, TX Heather M. Gilmartin, NP, CIC Adjunct Faculty University of Colorado, College of Nursing Aurora, CO Beth Ann Kavanagh, MT(ASCP), MS, MBA, CIC Director, Infection Control and Prevention University Health System Rebecca Larson, MPH Epidemiologist Eagle County Public Health & Environment Eagle, CO Jeanette Lepinski, MSN, RN, CIC Director of Infection Prevention and Control Sinai Health System Shilla Patel, OD, CIC III Infection Prevention/Clinical Department UC San Diego Health System La Jolla, CA Monika Pogorzelska-Maziarz, PhD, MPH Associate Research Scientist Columbia University School of Nursing New York, NY AUTHORS Emily A. Ackiss MPH, CIC Department of Infection Prevention and Control Oregon Health and Science University Portland, OR Vicki Allen, MSN, RN, CIC Infection Control Manager CaroMont Health Gastonia, NC Anucha Apisarnthanarak, MD Associate Professor Division of Infectious Diseases Thammasat University Hospital Pratumthani, Thailand Joann Archer, BTech, MA Educator/Consultant Provincial Infection Control Network Prince George, British Columbia, Canada Lennox K. Archibald, MD, PhD, FRCP, DTM&H Hospital Epidemiologist Malcom Randall VA Medical Center Gainesville, FL Kathleen Meehan Arias, MS, MT, SM, CIC Director Arias Infection Control Consulting, LLC Crownsville, MD vii

2 Forest W. Arnold, DO, MSc, FIDSA Assistant Professor, Division of Infectious Diseases University of Louisville Hospital Epidemiologist University of Louisville Hospital Hilary Babcock, MD Instructor, Infectious Diseases Washington University School of Medicine St. Louis, MO Tina Bair, BSN, RN, CIC Manager, Infection Prevention and Control Akron Children s Hospital Akron, OH Gio Baracco, MD, FACP Associate Professor of Clinical Medicine Division of Infectious Diseases University of Miami Miller School of Medicine Veterans Affairs Healthcare System Miami, FL Judene Bartley, MS, MPH, CIC Vice President Consulting Services, Inc. Beverly Hills, MI Karsten Becker, MD Professor of Medical Microbiology Institute of Medical Microbiology University Hospital of Munster Westfalian Wilhelms-University of Munster Munster, Germany Catherine Berends, RN, BSN, MS Sinai Health System Wendy Berg, BSN, RN, CIC Infection Prevention and Control Children s Hospitals and Clinics of Minnesota St. Paul, MN Sara Bienvenu, RN, MSN Clinical Manager, Infection Prevention Clinical Services Group HCA Hospital Corporation of America Nashville, TN Mandy Bodily-Bartrum, RN, MPH, CIC Director of Quality and Risk Management Vibra Hospital & Vista View Care Center Thornton, CO Kim M. Boynton-Delahanty, BSN, MBA/HCM, CIC Director Infection Prevention and Control and UCSD Healthcare San Diego, CA Kelley M. Boston, MPH, CIC Director of Accreditation and Regulatory Compliance Regional Director San Antonio Infection Prevention & Management Associates, Inc. Jason E. Bowling, MD Assistant Professor Department of Medicine/Division of Infectious Diseases Director of Hospital, University Health System The University of Texas Health Science Center at San Antonio David M. Brewer, DVM, DACVIM (Neurology) Neurologist/Neurosurgeon Bush Veterinary Neurology Service Leesburg, VA Michael Brown, PhD Professor Emeritus McDaniel College Westminster, MD Amelia C. Bumsted, BA, BS, RN, CRRN, CIC Wheaton Franciscan Health System Marianjoy Rehabilitation Hospital Wheaton, IL Jose Cadena, MD Assistant Professor of Medicine Department of Medicine/Infectious Diseases University of Texas Health Science Center at San Antonio Assistant Chief of Infectious Diseases Medical Director Infection Control South Texas Veterans Healthcare System Elizabeth A. Campbell, BS, RN, CIC Reston Hospital Center Reston, VA Harriette Carr, RN, MSN, CIC Carmichael, CA Ruth Carrico, PhD, RN, FSHEA, CIC Associate Professor Division of Infectious Diseases School of Medicine University of Louisville viii APIC Text of Infection Control and

3 Carol E. Chenoweth, MD Professor, Department of Internal Medicine, Division of Infectious Diseases Clinical Professor, Department of University of Michigan Health System Ann Arbor, MI Teresa Chou, MPH, MS, RN, CIC Manager, and Infection Prevention and Control Advocate Illinois Masonic Medical Center William E. Coll, MPUB, AFF, BA, LP, LEHS Program Manager Austin/Travis County EMS System Office of the Medical Director Austin, TX David K. C. Cooper, MD, PhD Thomas E. Starzl Transplantation Institute University of Pittsburg Medical Center Pittsburg, PA Brian Cotton, PE, CHFM, FASHE Executive Director of Design & Construction University of Arkansas for Medical Sciences Little Rock, AR Karen Cromwell, RN, MSM, CIC Deputy Chief, Infection Prevention and Control Service Walter Reed National Military Medical Center Bethesda, MD Christopher J. Crnich, MD Assistant Professor of Medicine Section of Infectious Diseases University of Wisconsin Medical School Infection Control Department Center for Trauma and Life Support University of Wisconsin Hospital and Clinics Madison, WI Ruth Curchoe, RN, MSN, CIC Infection Prevention Consultant Hilton, NY Stephen D. Cutter, MBA, HFDP, CHFM, SASHE Director of Facilities Dartmouth-Hitchcock Medical Center Lebanon, NH Kathleen T. Darling, MS, M, MT(ASCP), CIC Texas A&M University Veterinary Medical Teaching Hospital College Station, TX Michelle E. Day MSN, RN, CGRN Team Leader Comprehensive Liver Center Hartford Hospital Hartford, CT Linda Dickey, RN, MPH, CIC ICP/Clinical Professional Improvement University of California Irvine Medical Center Orange, CA Margaret A. Dudeck, MPH, CPH Epidemiologist Surveillance Branch Division of Healthcare Quality Promotion Centers for Disease Control and Prevention Atlanta, GA Melissa C. Dyson, DVM, MS, DACLAM Associate Professor and Assistant Director Unit for Laboratory Animal Medicine The University of Michigan Ann Arbor, MI Jonathan R. Edwards, MStat Research Mathematical Statistician Lead, Statistics Team Surveillance Branch Division of Healthcare Quality Promotion Centers for Disease Control and Prevention Atlanta, GA Larysa M. Fedoriw, MPH Healthcare and Infection Prevention Northwestern Medicine Carolyn Fiutem, BS, MT(ASCP), CIC Infection Prevention Officer Tri-Health Cincinnati, OH Annemarie Flood, RN, BSN, CIC Infection Prevention Program Manager City of Hope Duarte, CA Marie E. Fornof, RN, BSN, CIC National Jewish Health Denver, CO Janet Nau Franck RN, MBA, CIC / Consultant ix

4 Candace Friedman, MPH, CIC Project Manager/Office of Clinical Safety University of Michigan Health System Ann Arbor, Michigan Donald E. Fry, MD Adjunct Professor of Surgery Northwestern University Feinberg School of Medicine Bruce Gamage, RN, BSN, CIC IC Consultant BC Centre for Disease Control Vancouver, British Columbia, Canada Sylvia Garcia-Houchins, RN, MBA, CIC Director, Infection Control Program University of Chicago Medical Center Karen S. Geismar, MS, RD, LD, CNSC Lecturer, Department of Nutrition and Food Sciences Texas A&M University College Station, TX Joan Godich, BSN, RN Nurse Consultant Walter Reed National Military Medical Center Bethesda, MD Angella M. Goetz, RN, MNEd, CIC Senior Consultant Special Pathogens Laboratory Pittsburgh, PA Linda Goss, BS, MSN, APRN-NP, BC, CIC, COHN-S Norton Brownsboro Hospital Infectious Disease Nurse Practitioner Norton Infectious Disease Specialists Elicia A. Greene, RN, MSN, CIC, CPHQ Assistant Chief, IC Central Texas Veterans Health Care System Temple, TX Marguerite Gribogiannis, BS, MPA, CIC Advocate Lutheran General Hospital Park Ridge, IL Patti Grota, PhD, RN, CNS-M-S, CIC Assistant Professor Schreiner University Kerrville, TX Darragh Halpenny, MB BCh BAO, MRCPI, FFRRCSI Department of Radiology, Tallaght Hospital Dublin, Ireland Nancy G. Harless, BSN, MPH, CIC Infection Prevention Practitioner CaroMont Regional Medical Center Gastonia, NC Patricia L. Harris MSN, RN, CIC Nurse Manager Department of Veterans Affairs Veterans Affairs Pittsburgh Healthcare System Pittsburgh, PA Jennifer A. Harte, DDS, MS Colonel (ret) USAF, DC Dental Infection Prevention and Control Consultant Northville, MI Janet Hass, PhD, RN, CIC Director of Infection Prevention & Control Westchester Medical Center New York, NY Ann Henry, RN, MA, CIC Senior Blount Memorial Hospital Maryville, TN Carolyn T. A. Herzig, MS Project Director, Columbia University School of Nursing New York, NY Kimberly M. Hinckley, RN, BSN, CIC Senior Roswell Park Cancer Institute Buffalo, NY Kelly Holmes, MS, CIC Director of Education and Human Resources Regional Director Missouri and Eastern USA Infection Prevention & Management Associates, Inc. St. Louis, MO Kelly Holmes, MS, CIC Director of Education & Human Resources Regional Director Missouri and Eastern USA Infection Prevention & Management Associates, Inc. St. Louis, MO Lori K. Irwin, RN, MSN, CNS Professional Practice Leader Women and Children s Services Oregon Health and Sciences University Portland, OR x APIC Text of Infection Control and

5 Pamela Iwamoto, MSN, RN, CIC Sr. RN Case Manager University of New Mexico College of Nursing Consultant University of New Mexico Medical Group Albuquerque, NM Julie Jefferson, RN, MPH, CIC Director, and Infection Control Rhode Island Hospital Providence, RI Dawn Jourdan, RN, BSN Clinical Quality Coordinator The Nebraska Medical Center Omaha, NE Eric S. Kastango, MBA, RPh, FASHP Principal-CEO Clinical IQ, LLC Madison, NJ Beth Ann Kavanagh, MT(ASCP), MS, MBA, CIC Director, Infection Control and Prevention University Health System Robert R. Kelley, PhD Assistant Professor of Medicine Assistant Director of Data Management and Analysis University of Louisville School of Medicine Division of Infectious Diseases Clinical and Translational Research Support Center Irena Kenneley, PhD, APRN-BC, CIC Assistant Professor, Faculty Development Director Case Western Reserve University Cleveland, OH Patricia C. Kienle, RPh, MPA, FASHP Director of Accreditation and Medication Safety Cardinal Health Pharmacy Solutions Wilkes-Barre, PA Robin Kock, MD Institute of Hygiene University Hospital of Munster Westfalian Wilhelms-University of Munster Munster, Germany Kathleen Kohut, MS, BSN, RN, CIC, CNOR System Director, Infection Prevention Cone Health Greensboro, NC Hong Kuan Kok, MB BCh BAO, BMedSci, MRCPI, MRCP(UK) Department of Radiology Tallaght Hospital Dublin, Ireland Sharron Knox, BSN, RN, CIC Specialty Hospital Jacksonville Jacksonville, FL Eric Lee, MT(ASCP) CaroMont Regional Medical Center Gastonia, NC Jeanette Lepinski, MSN, RN, CIC Director of Infection Prevention & Control Sinai Health System Jan Lienau, BSN, RN, CIC II Greer Medical Campus Greenville Health System Greer, SC Peggy Prinz Luebbert, MS, MT(ASCP), CIC, CHSP Healthcare Interventions, Inc. Omaha, NE Dennis G. Maki, MD Ovid O. Meyer Professor of Medicine Section of Infectious Diseases University of Wisconsin Medical School Infection Control Department Center for Trauma and Life Support University of Wisconsin Hospital and Clinics Madison, WI Anil Mangla, MD Chief Epidemiologist San Antonio Metropolitan Health District Nedra D. Marion, RN, BSN, MPA, CIC Manager, Department of Infection Control and The Nebraska Medical Center Omaha, NE Carol McLay, DrPH, BSN, RN, CIC Infection Prevention Consultant Lexington, KY Nancy Mendicino, RN, MSN, CIC ICP Director Christus Santa Rosa Health Care xi

6 Darlene Miller, DHSc, MPH, MA, SM (NRM, ASCP), MT (ASCP), CIC Research Associate Professor Department of Ophthalmology Scientific Director Abrams Ocular Microbiology Laboratory Anne Bates Leach Eye Hospital/Bascom Palmer Eye Institute University of Miami Miller School of Medicine Miami, FL Sonia Miller, RN, BSN, MSN, CIC Chief, Infection Prevention & Control Fort Belvoir Community Hospital Fort Belvoir, VA John Molinari, PhD Director of Infection Control, The Dental Advisor Ann Arbor, MI Elizabeth Monsees, RN, MSN, MBA, CIC Children s Mercy Hospitals & Clinics Kansas City, MO Julia Moody, MS, SM(ASCP) Clinical Director, Infection Prevention Clinical Services Group HCA Hospital Corporation of America Nashville, TN Gloria Morrell, RN, MS, MSN, CIC Nurse Consultant Centers for Disease Control and Prevention Atlanta, GA Linda M. Mundy, MD, PhD Director, Worldwide Research and Development, GlaxoSmithKline Collegeville, PA Rebecca J. Murphy, RN, MSN, CNOR Perioperative Services Outcomes Manager Central DuPage Hospital Winfield, IL Deborah M. Nadzam, PhD, RN, BB, FAAN Practice Leader, Patient Safety Services Joint Commission Resources Oak Brook, IL Casey P. Neary, DVM Veterinary Neurology/Neurosurgery Bush Veterinary Neurology Service Leesburg, VA Doris Neumeyer, RN, BSN Administrative Nurse Clinician William Beaumont Hospital-Troy Troy, MI Deborah M. Nihill, RN, MSA, CIC, CPHQ Director, Quality Management Mercy Hospital St. Louis, MO Ann-Christine Nyquist, MD, MSPH Medical Director, Infection Prevention and Control Children s Hospital Colorado Professor of Pediatrics, Section of Infectious Diseases and University of Colorado School of Medicine Aurora, CO Russell N. Olmsted, MPH, CIC Epidemiologist, Infection Control Services Saint Joseph Mercy health System Ann Arbor, MI Ynes Ortega, PhD, MPH Associate Professor Center for Food Safety University of Georgia Griffin, GA Belinda Ostrowsky, MD, MPH Director of Antimicrobial Stewardship Associate Professor of Medicine Montefiore Medical Center Bronx, NY William J. Pate, BS, MPH, DPH Safety Manager, Environment of Care University Health System Thomas F. Patterson, MD, FACP, FIDSA Professor of Medicine Chief, Division of Infectious Diseases The University of Texas Health Science Center at San Antonio Staff Physician, South Texas Veterans Healthcare System Sindy M. Paul, MD, MPH, FACPM Medical Director Division of HIV, STD, and TB Services New Jersey Department of Health Trenton, NJ Michael A. Pentella, PhD, CIC, D (ABMM) Director, Bureau of Laboratory Sciences William A. Hinton State Laboratory Institute Jamaica Plain, MA xii APIC Text of Infection Control and

7 Cheryl Perego, MPH, MT(ASCP), CIC Supervisor, Infection Control University of Texas MD Anderson Cancer Center Houston, TX Paula Peyrani, MD Instructor of Medicine Project/Medical Director, HIV clinic Assistant Director, Research Design and Development Clinical and Translational Research Support Center Division of Infectious Diseases University of Louisville Jeanne Pfeiffer, DNP, MPH, RN, CIC Clinical Assistant (*Associate) Professor University of Minnesota School of Nursing Minneapolis, MN Monika Pogorzelska-Maziarz, PhD, MPH Associate Research Scientist Columbia University School of Nursing New York, NY Patricia Posa, RN, BSN, MSA, FAAN System Performance Leader St Joseph Mercy Health System Ypsilanti, MI Mary T. Post, RN, MS, CNS, CIC Director, Infection Prevention Oregon Patient Safety Commission Portland, OR Arlene Potts, BA, MPH, CIC Research Scientist New Jersey State Department of Health Trenton, NJ Michael Anne Preas, RN, BSN, CIC Director, Infection Prevention University of Maryland Medical Center Baltimore, MD Ruby Puckett, MA, RD, FCSI, CFE President, Foodservice Management Consultants Program Director, Dietary Manager Training University of Florida Gainesville, FL Terri Rebmann, PhD, RN, CIC Associate Professor Director, Institute for Biosecurity Saint Louis University College for Public Health & Social Justice St. Louis, MO Julie A. Ribes, MD, PhD Professor of Pathology and Laboratory Medicine University of Kentucky Chandler Medical Center Lexington, KY Kathleen Roye-Horn, RN, CIC Consultant Horn IP Consulting Fleming, NJ Robin Roach, BSN, MS, CIC Director, Infection Prevention and Control Oregon Health and Science University Portland, OR Howard G. Rush, DVM, MS, DACLAM Associate Professor Unit for Laboratory Animal Medicine The University of Michigan Ann Arbor, MI William A. Rutala, PhD, MPH Department of Hospital, University of North Carolina Health Care Division of Infectious Diseases, UNC School of Medicine Chapel Hill, NC Keith St. John, MS, MT(ASCP), CIC Director, Clinical Pharmacy OneSource - Sentri7 Wolters Kluwer Health Bellevue, WA Kim Schmit-Pokorny, RN, MSN, OCN Manager Blood and Marrow Transplantation Program Oncology/Hematology Division University of Nebraska Medical Center Omaha, NE Sue Sebazco, RN, MBA, CIC Director of IC & Employee Health & Education Texas Health Arlington, TX Brigid Sheridan, RN, JD Associate General Council University Health System Justin Smyer, MLS(ASCP) CM, MPH, CIC University Hospital East Department of Clinical The Ohio State University Wexler Medical Center Columbus, OH xiii

8 Barbara M. Soule, RN, MPA, CIC, FSHEA Practice Leader, Infection Prevention Services Joint Commission Resources Oak Brook, IL Valerie Sparks, BSN, CIC Midland Memorial Hospital Midland, TX Steven Spencer, MD, FAAP COL, MC, USA Chief, Pediatric Ward 3W Walter Reed National Military Medical Center Bethesda, MD Patricia Stone, RN, PhD, FAAN Centennial Professor of Health Policy Columbia University School of Nursing New York, NY Janet E. Stout, PhD Special Pathogens Laboratory Department of Civil and Environmental Engineering University of Pittsburgh, Swanson School of Engineering Pittsburgh, PA Kathryn N. Suh, MD, FRCPC, CIC Associate Director, Infection Prevention and Control The Ottawa Hospital, Civic Campus Ottawa, Ontario, Canada Mary C. Thomas, MB, BS, DTM&H, MPH Senior Epidemiologist San Antonio Metropolitan Health District George R. Thompson, MD Assistant Professor of Medicine Department of Medicine, Division of Infectious Diseases Co-director, Coccidioidomycosis Serology Laboratory Department of Medical Microbiology and Immunology University of California - Davis Davis, CA Alexander Tomich, DNP, RN, CIC Director, Infection Prevention and Control Rush University Medical Center William C. Torreggiani, MB BCh BAO, MRCPI, FFR- RCSI, FRCR Department of Radiology Tallaght Hospital Dublin, Ireland S. Samantha M. Tweeten, PhD, MPH Epidemiologist & Immunization Services Branch Health and Human Services Agency County of San Diego San Diego, CA Amanda Valyko, MPH, CIC Infection Control & University of Michigan Health System Ann Arbor, MI Brian Walsea, MPH, CIC Sinai Health System Tyler E. Warkentien, MD, FACP Infectious Disease Department Walter Reed National Military Medical Center Bethesda, MD David J. Weber, MD, MPH Department of Hospital, University of North Carolina Health Care Division of Infectious Diseases, UNC School of Medicine Chapel Hill, NC Joan Weber, RN, BSN, CIC Shriners Hospitals for Children-Boston Boston, MA Kelly L. West, MS, RN, CIC Children s Hospital Colorado Aurora, CO Katherine H. West, RN, BSN, MSEd Infection Control Consultant Infection Control/Emerging Concepts, Inc. Manassas, VA Timothy L. Wiemken, PhD, MPH, CIC Assistant Professor of Medicine Director, University of Louisville Hospital Program Assistant Director of and Biostatistics University of Louisville School of Medicine Division of Infectious Diseases Clinical and Translational Research Support Center xiv APIC Text of Infection Control and

9 Tiffany Wiksten, BSN, RN Infection Prevention Practitioner Advocate Christ Medical Center and Advocate Children s Hospital, Oak Lawn Oak Lawn, IL Randall D. Wolcott, MD Founder and President Southwest Regional Wound Care Center Lubbock, TX Carole Yeung, RN, CIC Infection Prevention Baptist Home Health Network Little Rock, AR Martha Young, MS, BS, CSPDT Consultant SAVVY Sterilization Solutions Woodbury, MN John Anthony Zaia, MD Professor and Chair, Department of Virology Beckman Research Institute, City of Hope Medical Center Duarte, CA REVIEWERS Vicki Allen, MSN, RN, CIC Infection Control Manager CaroMont Health Gastonia, NC Anne Augustin, MLT, CIC Infection Prevention & Control Coordinator Headwaters Healthcare Center Orangeville, Ontario, Canada Kathy Aureden MS, MT(ASCP)SI, CIC Coordinator Sherman Hospital Elgin, IL Ruth Belflower, MPH, RN Hardin Memorial Hospital Elizabethtown, KY Molly Blake, BN, MHS, GNC(C), CIC Program Director Winnipeg Regional Health Authority Winnipeg, Mannitoba, Canada Sue Boeker, BSN, RN, CIC Greenville Health System Greenville, SC Lynette Boland, RNC, CIC Kosiar Children s Hospital Judie Bringhurst, RN, MSN, CIC Ambulatory Care /Safety Compliance Officer University of North Carolina Health System Chapel Hill, NC Tania Bubb, RN, MS, CIC Infection Prevention and Control Practitioner NYU Langone Medical Center Mount Vernon, NY Amelia Bumsted, BA, BS, RN, CRRN, CIC Marianjoy Rehabilitation Hospital Wheaton, IL Jose Cadena Zuluaga, MD Infectious Diseases South Texas Veterans Healthcare Administration/University Health Science Center Lisa Caffery, MS, BSN, RN-BC, CIC Infection Prevention Coordinator Genesis Medical Center Davenport, IO Barbara Catt, RN, BSN, CIC, Med Infection Prevention & Control Coordinator Sunnybrook Health Sciences Centre Keswick, Ontario, Canada Harriette Carr, RN, MSN, CIC Carmichael, CA Gwen Cerkowniak, RN, BSN, CIC Provincial Saskatoon Health Region Saskatoon, Saskatchewan, Canada Michael Cloughessy, MS, BSEH, REHS, CIC Senior Cincinnati Children s Hospital Cincinnati, OH Dorthea Davis, RPN Infection Control Officer Selkirk Mental Health Centre Selkirk, Manitoba, Canada xv

10 Kim Delahanty, BSN, MBA/HCM, CIC Administrative Director UCSD Health System San Diego, CA Gemma Downham, MPH, CIC Infection Prevention Epidemiologist AtlantiCare Regional Medical Center Pomona, NJ Brenda Ehlert, MT(ASCP), CIC Infection Prevention Coordinator Affinity Health System Oshkosh, WI Julia Frith, RN, MSN, CIC Infection Prevention Kosair Children s Hospital Therese Flood, RN, BSN Infection Control Nurse Baptist Hospital East Marie Fornof, RN, BSN, CIC National Jewish Health Highlands, CO Gail Fraine, RN, MMHC, BSN, CIC Director Infection Prevention Saint Thomas Midtown Hospital (formerly Baptist Hospital) Nashville, TN Melissa Fugate, BSN, RN, CIC Baptist Health Louisville Kate Gase, MPH, CIC Hospital Acquired Infection Reporting Program Regional Representative Memorial Sloan Kettering Cancer Center New York, NY Kasey Gambeta, BScN, RN, MN Infection Control Professional St. Michael s Hospital Toronto, Ontario, Canada Patricia Gould, RN, BSN Manager, Infection Control Jewish Hospital Patti Grota, PhD, RN, CNS-M-S, CIC Assistant Professor Schreiner University Kerrville, TX Deborah Harkness, RegN., MScN Infection Prevention and Control Practitioner Northumberland Hills Hospital Cobourg, Ontario, Canada Eddie Hedrick, BS, MT(ASCP), CIC Emerging Infections Coordinator Missouri Dept of Health & Senior Services Columbia, MO Crystal Heishman, BSN, RN, CIC, ONC University of Louisville Healthcare Tricia Herridge, BSC, BEH, CPHI(C) Public Health Inspector Alberta Health Services Camrose, Alberta, Canada Sally Hess, MPH Manager Infection Prevention Fletcher Allen Health Care Burlington, VT Steve Hilley, RN Infection Prevention Coordinator Yampa Valley Medical Center Steamboat Springs, CO Kimberly Hinckley, RN, BSN, CIC Sr. Roswell Park Cancer Institute Buffalo, NY Jill Holdsworth, MS, CIC, EMT-B INOVA Mount Vernon Hospital Alexandria, VA Sandra Hyman, RN, MPA, CIC Infection Prevention Specialist New York Presbyterian - Columbia University Medical Center New Rochelle, NY Sharon Jacobs, RN, MS, CIC Bridgeville, PA Debra Johnson, BSN, RN, CIC Infection Prevention Nurse Stanford Hospital & Clinics Stanford, CA xvi APIC Text of Infection Control and

11 Marie Kassai, RN, BSN, MPH, CIC Infection Prevention Consultant MRK Consulting, LLC West Paterson, NJ Irena Kenneley, PhD, APRN-BC, CIC Assistant Professor Case Western Reserve University Cleveland, OH Anjum Khan, MBBS, MSc St. Michael s Hospital Toronto, Ontario, Canada Patrick J. Kleinkort, RN, BSN, MHA, CIC Epidemiologist Broward Health Coral Springs Coral Springs, FL Jessica Kooger, BSC, HONS, CIC Infection Control Director Norfolk General Hospital Simcoe, Ontario, Canada Ben Kung, BSc, BTech Coordinator, Infection Prevention & Control College of Physicians & Surgeons of Alberta Edmonton, Alberta, Canada Melanie Lipka, BSc Client Care Specialist and Trainer HandyMetrics Corporation Toronto, Ontario, Canada Michelle Luscombe, RN Regional Infection Control Nurse Sun Country Health Region Wawota, Saskatchewan, Canada Jo Ellen Mackey, RN, BSN, CIC Infection Prevention Nurse Consultant Irealand Army Community Health Ft Knox, KY Judy McCarten, RN, CIC Infection Control Professional Lakeridge Health Oshawa, Ontario, Canada Mark McCaulley, MD Infection Prevention Physician Advisor Yampa Valley Medical Center Steamboat Springs, CO Shirley McDonald, ART, CIC IPAC Resource Expert Public Health Ontario Bath, Ontario, Canada Jacquelyn McKnight, LPN, RPN, CFCN, NACICP Council, College of Nurses of Ontario, VP IB/SIG RPNAO Elliot Lake Foot Care Elliot Lake, Ontario, Canada Carol McLay, DrPH, BSN, RN, CIC Infection Prevention Consultant Lexington, KY Caroline Meguerditchian The Perley and Rideau Veterans Health Centre Ottawa, Ontario, Canada Elizabeth Monsees, RN, MSN, MBA, CIC Children s Mercy Hospitals & Clinics Kansas City, MO Christine Moore, MLT, BSc, CIC Infection Control Educator Mount Sinai Hospital Toronto, Ontario, Canada Frank Myers III, MA, CIC UC San Diego Healthcare Systems San Diego, CA Pam Nolting, RN, MSN, CIC Infection Control Professional University of Louisville Hospital Christopher Okeahialam, MSc, CIC Infection Prevention and Control Consultant Public Health Ontario Toronto, Ontario, Canada Neil Pascoe, RN, BSN, CIC Nurse Epidemiologist Texas Department of Health Austin, TX Marcia Patrick, RN, MSN, CIC Infection Prevention Consultant Tacoma, WA Luci Perri, RN, MSN, MPH Infection Prevention Manager Perri IPC Consulting Wingate, NC xvii

12 Ann Marie Pettis, RN, BSN, CIC Director University of Rochester Medical Center Rochester, NY Michael Anne Preas, RN, CIC University of Maryland Medical Center Baltimore, MD Kit Reed, RN, BSN, MPH, CIC Infection Prevention Specialist Charleston Area Medical Center Charleston, WV Kathy Roye-Horn, RN, CIC Infection Prevention Consultant Horn IP Consulting Flemington, NJ Teresa Rybacki-Anisko, RN, BSC, CIC Infection Control Professional Mississauga, Ontario, Canada Deanna Samms, BS, MA, CIC Charleston Area Medical Center Charleston, WV Steve Schweon, RN, MPH, MSN, CIC, HEN Infection Prevention Consultant Saylorsburg, Pennsylvania Jane Stafford, RN, BN, CIC Consultant IPAC Dept of Health, Province of New Brunswick Fredericton, New Brunswick, Canada Charla C. Tully, DO, FACP Major, USAF, MC Infectious Disease Physician Medical Director, Infection Control San Antonio Military Medical Center Fort Sam Houston Carole VanAntwerpen, RN, BSN, CIC Consultant, Infection Prevention and Clifton Park, NY William Wagner, ScD, CHCM, CHSP, CHEP Vice President, Quality Compliance TSIG Consulting Marietta, GA Tonya Wagner, BSN Elms Eye Center Summerville, SC Leslie Walker-Rice, BSCN Infection Prevention and Control Nurse Kateri Memorial Hospital Center Kahnawake, Quebec, Canada Kathy Ward, RN, BSN, MPH, CIC Roper Hospital Charleston, SC David Weber, MD, MPH, MHA Professor of Medicine, Pediatrics, and University of North Carolina Chapel Hill Chapel Hill, NC Maria Whitaker, MT, CIC Cortland Regional Medical Center Cortland, NY Sharon Winefordner, RN, BSN, CIC Charleston Area Medical Center Charleston, WV Martha Young, MS, BS, CSPDT Consultant SAVVY Sterilization Solutions Woodbury, MN Nancy Zanotti, RN, BSN, MPH, CIC Director, Infection Control Westside Regional Medical Center Plantation, FL Kelly Zink, RN, CIC Kosair Children s Hospital Georgetown, ID xviii APIC Text of Infection Control and

13 PRODUCTION STAFF Managing Editor Thomas Weaver, DMD Director, Professional Practice Editorial Assistance and Project Support Jim Angelo Director, Publishing Anna Conger Associate Director, Publishing Christina James Practice Resources Coordinator Additional assistance was provided by the following APIC staff members: Dave Bentley Marketing Manager Janiene Bohannon Associate Director, Communications Correen Dingle Marketing Manager Caroline Fuchs, CAE Senior Director, Marketing Elizabeth Garman Senior Director, Communications Kathryn Hitchcock Project Manager Lynn Schneider Senior Director, Human Resources Cover Design Project Design Company Book Design and Layout Maryland Comp Laurel, MD Printing AGS, An RR Donnelley Company White Plains, MD xix

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15 Declarations of Conflicts of Interest Only individuals who have made declarations of potential conflicts have been listed here. Kathleen (Kit) Darling currently serves on the board of directors for Aggieland Pets With A Purpose (President) and Aggieland Humane Society. No financial compensation is received. Michelle Day is Director of Regional Societies for Society of Gastroenterology Nurses and Associates. Donald Fry serves on the Board of the Surgical Infection Foundation and is a past president of the organization. He is currently a member of 25 surgical societies and holds no offices for any of these societies at the time of publication. He speaks periodically on surgical infections for Merck and has been a consultant and speaker for Ethicon on two occasions within the last year. At the time of publication, Dr. Fry was organizing a controlled clinical trial for the IrrlMax Company on the use of an innovative application of dilute chlorhexidine in the surgical wound. Bruce Gamage is currently president of Infection Prevention and Control Canada (IPAC Canada). Patricia Kienle is currently employed by Cardinal Health. Rebecca Murphy is currently the treasurer for her local Association of perioperative Registered Nurses chapter. William Pate was elected board member for the South Texas Chapter of the Health Physics Society through April He is also employed by The University of Texas Medical Branch as an Environmental Health and Safety Consultant. William Rutala served as a consultant for Advanced Sterilization Products and Clorox. Keith St. John is currently employed by Wolters Klower Health. David J. Weber served as a consultant for Johnson & Johnson and Clorox. Timothy Wiemken serves on the Society for Healthcare of America guidelines committee, received grant funding from Clorox Healthcare, is on the speaker bureau for Sanofi Pasteur. xxi