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Overview :
Friedman et al evaluated bloodstream infections in patients
who have had an association with health care facility or provider prior to
onset. The isolates from these patients tend to resemble nosocomial pathogens,
with an increased risk for antibiotic-resistant organisms. The authors are from
Duke University, Durham Regional Hospital and Nash General Hospital in North
Carolina.
Criteria for health-care associated blood stream
infection:
(1)
positive blood culture collected on hospital admission or within 48 hours of
admission (or as an outpatient)
(2) blood
culture isolate clinically significant (not a contaminant)
(3) one or
more associations with health care
Associations with health-care:
(1) home
therapy within previous 30 days, including IV therapy, wound care or specialized
nursing care
(2)
attended a hospital clinic within previous 30 days
(3)
attended a hemodialysis clinic within previous 30 days
(4)
receiving IV chemotherapy within the previous 30 days
(5)
residing in a nursing home or long-term care facility
(6)
hospitalized for >= 2 days within the previous 90 days (an infection
occurring shortly after discharge would be classified as nosocomially
acquired)
A person with a positive blood culture who does not meet
criteria for a nosocomial or health-care associated infection is considered to
have a community-acquired bloodstream infection.
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