CDC Definitions of Nosocomial Infections (PDF) - CPCCRN

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Chapter 94: Surveillance of Nosocomial Infections 1681symptoms with no other recognized cause: fever(38C), erythema of pharynx, sore throat,cough, hoarseness, of purulent exudate in throatandat least one of the following:a. Organisms cultured from the specific siteb. Organisms cultured from bloodc. Positive antigen test on blood or respiratorysecretionsd. Diagnostic single antibody titer (IgM) or fourfoldincrease in paired sera (IgG) for pathogene. Physician’s diagnosis of an upper respiratoryinfectionCriterion 2: Patient has an abscess seen on direct examination,during a surgical operation, or during a histopathologicexamination.Criterion 3: Patient 1 year of age has at least two of the followingsigns or symptoms with no other recognizedcause: fever (38C), hypothermia(37C), apnea, bradycardia, nasal discharge, orpurulent exudate in throatandat least one of the following:a. Organisms cultured from the specific siteb. Organisms cultured from bloodc. Positive antigen test on blood or respiratorysecretionsd. Diagnostic single antibody titer (IgM) or fourfoldincrease in paired sera (IgG) for pathogene. Physician’s diagnosis of an upper respiratoryinfectionINFECTION SITE: GastroenteritisCODE: GI-GEDEFINITION: Gastroenteritis must meet at least one of thefollowing criteria:Criterion 1: Patient has an acute onset of diarrhea (liquid stoolsfor more than 12 hours) with or without vomitingor fever (38C) and no likely noninfectiouscause (e.g., diagnostic tests, therapeutic regimen,acute exacerbation of a chronic condition, or psychologicstress).Criterion 2: Patient has at least two of the following signs orsymptoms with no other recognized cause: nausea,vomiting, abdominal pain, or headacheandat least one of the following:a. An enteric pathogen is cultured from stool orrectal swabb. An enteric pathogen is detected by routine orelectron microscopyc. An enteric pathogen is detected by antigen orantibody assay on blood or fecesd. Evidence of an enteric pathogen is detected bycytopathic changes in tissue culture (toxinassay)e. Diagnostic single antibody titer (IgM) or fourfoldincrease in paired sera (IgG) for pathogenINFECTION SITE: GI tract (esophagus, stomach, small andlarge bowel, and rectum) excluding gastroenteritis and appendicitisCODE: GI-GITDEFINITION: Gastrointestinal tract infections, excluding gastroenteritisand appendicitis, must meet at least one of the followingcriteria:Criterion 1: Patient has an abscess or other evidence of infectionseen during a surgical operation or histopathologicexamination.Criterion 2: Patient has at least two of the following signs orsymptoms with no other recognized cause andcompatible with infection of the organ or tissueinvolved: fever (38C), nausea, vomiting, abdominalpain, or tendernessandat least one of the following:a. Organisms cultured from drainage or tissue obtainedduring a surgical operation or endoscopyor from a surgically placed drainb. Organisms seen on Gram or KOH stain ormultinucleated giant cells seen on microscopicexamination of drainage or tissue obtained duringa surgical operation or endoscopy or froma surgically placed drainc. Organisms cultured from bloodd. Evidence of pathologic findings on radiologicexaminatione. Evidence of pathologic findings on endoscopicexamination (e.g., Candida esophagitis or proctitis)INFECTION SITE: HepatitisCODE: GI-HEPDEFINITION: Hepatitis must meet the following criterion:Patient has at least two of the following signs or symptoms withno other recognized cause: fever (38C), anorexia, nausea,vomiting, abdominal pain, jaundice, or history of transfusionwithin the previous 3 monthsandat least one of the following:a. Positive antigen or antibody test for hepatitisA, hepatitis B, hepatitis C, or delta hepatitisb. Abnormal liver function tests (e.g., elevated alanine/aspartateaminotransferases, bilirubin)c. Cytomegalovirus detected in urine or oropharyngealsecretionsREPORTING INSTRUCTIONS:Do not report hepatitis or jaundice of noninfectious origin(alpha-1 antitrypsin deficiency, etc.).Do not report hepatitis or jaundice that results from exposureto hepatotoxins (alcoholic or acetaminophen-induced hepatitis,etc.).Do not report hepatitis or jaundice that results from biliaryobstruction (cholecystitis).INFECTION SITE: Intraabdominal, including gallbladder, bileducts, liver (excluding viral hepatitis), spleen, pancreas, perito-
1682Section XV: Organization and Implementation of Infection Control Programsneum, subphrenic or subdiaphragmatic space, or other intraabdominaltissue or area not specified elsewhereCODE: GI-IABDEFINITION: Intraabdominal infections must meet at leastone of the following criteria:Criterion 1: Patient has organisms cultured from purulent materialfrom intraabdominal space obtained duringa surgical operation or needle aspiration.Criterion 2: Patient has abscess or other evidence of intraabdominalinfection seen during a surgical operationor histopathologic examination.Criterion 3: Patient has at least two of the following signs orsymptoms with no other recognized cause: fever(38C), nausea, vomiting, abdominal pain, orjaundiceandat least one of the following:a. Organisms cultured from drainage from surgicallyplaced drain (e.g., closed suction drainagesystem, open drain, T-tube drain)b. Organisms seen on Gram stain of drainage ortissue obtained during surgical operation orneedle aspirationc. Organisms cultured from blood and radiographicevidence of infection, for example, abnormalfindings on ultrasound, CT, MRI, orradiolabel scans (gallium, technetium, etc.) oron abdominal x-rayREPORTING INSTRUCTION:Do not report pancreatitis (an inflammatory syndrome characterizedby abdominal pain, nausea, and vomiting associatedwith high serum levels of pancreatic enzymes) unless it isdetermined to be infectious in origin.INFECTION SITE: Necrotizing enterocolitisCODE: GI-NECDEFINITION: Necrotizing enterocolitis in infants must meetthe following criteria:Infant has at least two of the following signs or symptoms withno other recognized cause: vomiting, abdominal distention, orprefeeding residualsandpersistent microscopic or gross blood in stoolsandat least one of the following abdominal radiographic abnormalities:a. Pneumoperitoneumb. Pneumatosis intestinalisc. Unchanging ‘‘rigid’’ loops of small bowelINFECTION SITE: Bronchitis, tracheobronchitis, bronchiolitis,tracheitis, without evidence of pneumoniaCODE: LRI-BRONDEFINITION: Tracheobronchial infections must meet at leastone of the following criteria:Criterion 1: Patient has no clinical or radiographic evidence ofpneumoniaandpatient has at least two of the following signs orsymptoms with no other recognized cause: fever(38C), cough, new or increased sputum production,rhonchi, wheezingandat least one of the following:a. Positive culture obtained by deep tracheal aspirateor bronchoscopyb. Positive antigen test on respiratory secretionsCriterion 2: Patient 1 year of age has no clinical or radiographicevidence of pneumoniaandpatient has at least two of the following signs orsymptoms with no other recognized cause: fever(38C), cough, new or increased sputum production,rhonchi, wheezing, respiratory distress,apnea, or bradycardiaandat least one of the following:a. Organisms cultured from material obtained bydeep tracheal aspirate or bronchoscopyb. Positive antigen test on respiratory secretionsc. Diagnostic single antibody titer (IgM) or fourfoldincrease in paired sera (IgG) for pathogenREPORTING INSTRUCTION:Do not report chronic bronchitis in a patient with chroniclung disease as an infection unless there is evidence of an acutesecondary infection, manifested by change in organism.INFECTION SITE: Other infections of the lower respiratorytractCODE: LRI-LUNGDEFINITION: Other infections of the lower respiratory tractmust meet at least one of the following criteria:Criterion 1: Patient has organisms seen on smear or culturedfrom lung tissue or fluid, including pleural fluid.Criterion 2: Patient has a lung abscess or empyema seen duringa surgical operation or histopathologic examination.Criterion 3: Patient has an abscess cavity seen on radiographicexamination of lung.REPORTING INSTRUCTIONS:Report concurrent lower respiratory tract infection and pneumoniawith the same organism(s) as PNEU.Report lung abscess or empyema without pneumonia asLUNG.INFECTION SITE: EndometritisCODE: REPR-EMETDEFINITION: Endometritis must meet at least one of the followingcriteria:Criterion 1: Patient has organisms cultured from fluid or tissuefrom endometrium obtained during surgical operation,by needle aspiration, or by brush biopsy.Criterion 2: Patient has at least two of the following signs orsymptoms with no other recognized cause: fever
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CDC Definitions of Nosocomial Infections (PDF) - CPCCRN

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