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Volume 7, Number 2—April 2001
4th Decennial International Conference on Nosocomial and Healthcare-Associated Infections

Prevention is Primary

Infection Control in Home Care

Emily RhinehartComments to Author 
Author affiliation: AIG Consultants, Inc., Atlanta, Georgia, USA

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Criteria for inclusion in definitions of home-care-acquired infectiona

Site of infection Clinical data Laboratory data
Catheter-related UTIb Change in characteristics of urine Elevated serum leukocytes
Fever Evidence of UTI in urinalysis
Pain Evidence of leukocytes in urine dipstick test
Positive urine culture (>105 CFU of a single organism per mL urine)
Postoperative pneumonia Change in character of sputum Elevated serum leukocytes
Decreased breath sounds Sputum Gram-stained smear with
Increase in rales and rhonchi evidence of respiratory infection
Fever Positive sputum culture
Shortness of breath Positive chest X ray
Catheter-related bloodstream infection Fever with chills and rigors Elevated serum leukocytes
Redness, tenderness, or pain at insertion site Positive blood culture
Purulent drainage at site Positive catheter culture (after catheter removal)
Skin and soft tissue infection Pain, swelling, tenderness at site Gram-stain smear with leukocytes and organisms
Inflammation and warmth Positive culture
Purulent drainage Elevated serum leukocytes
Endometritis in postpartum patients Uterine tenderness and abdominal pain Positive Gram-stain smear of lochia
Purulent vaginal drainage (lochia) Positive culture of lochia
Foul-smelling lochia Remarkably elevated serum leukocytes

aSource: Rhinehart E, Friedman M. Infection control in home care. Gaithersburg (MD): Aspen Publishing, Inc.;1999 (22). bUTI = urinary tract infection.

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