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Acknowledgments The Association for Professionals in Infection Control and Epidemiology 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. San Antonio, TX Amelia C. Bumsted, BA, BS, RN, CRRN, CIC Infection Control Coordinator Wheaton Franciscan Health System Marianjoy Rehabilitation Hospital Wheaton, IL Laurie J. Conway RN, MPhil, CIC Columbia University School of Nursing New York, NY 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 Chicago, IL Shilla Patel, OD, CIC Infection Preventionist III Infection Prevention/Clinical Epidemiology 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 Infection Preventionist 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 Lynn Slonim Fine PhD, MPH, CIC Infection Prevention Program University of Rochester Medical Center Rochester, NY Anucha Apisarnthanarak, MD Associate Professor Division of Infectious Diseases Thammasat University Hospital Pratumthani, Thailand Christopher E. Florez, MPH, CIC Program Director, EPIC Course 383rd Training Squadron Joint Base Fort Sam Houston, TX Joann Archer, BTech, MA Educator/Consultant Provincial Infection Control Network Prince George, British Columbia, Canada Heather M. Gilmartin, NP, CIC Adjunct Faculty University of Colorado, College of Nursing Aurora, CO Lennox K. Archibald, MD, PhD, FRCP, DTM&H Hospital Epidemiologist Malcom Randall VA Medical Center Gainesville, FL Beth Ann Kavanagh, MT(ASCP), MS, MBA, CIC Director, Infection Control and Prevention University Health System San Antonio, TX Kathleen Meehan Arias, MS, MT, SM, CIC Director Arias Infection Control Consulting, LLC Crownsville, MD vii Forest W. Arnold, DO, MSc, FIDSA Assistant Professor, Division of Infectious Diseases University of Louisville Hospital Epidemiologist University of Louisville Hospital Louisville, KY 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 Epidemiology 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 Infection Control Practitioner Sinai Health System Chicago, IL Wendy Berg, BSN, RN, CIC Infection Preventionist 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 viii Kim M. Boynton-Delahanty, BSN, MBA/HCM, CIC Director Infection Prevention and Control and Epidemiology 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. San Antonio, TX Jason E. Bowling, MD Assistant Professor Department of Medicine/Division of Infectious Diseases Director of Hospital Epidemiology, University Health System The University of Texas Health Science Center at San Antonio San Antonio, TX 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 Infection Control Coordinator 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 San Antonio, TX Elizabeth A. Campbell, BS, RN, CIC Infection Control Coordinator Reston Hospital Center Reston, VA Harriette Carr, RN, MSN, CIC Infection Preventionist Carmichael, CA Ruth Carrico, PhD, RN, FSHEA, CIC Associate Professor Division of Infectious Diseases School of Medicine University of Louisville Louisville, KY APIC Text of Infection Control and Epidemiology Carol E. Chenoweth, MD Professor, Department of Internal Medicine, Division of Infectious Diseases Clinical Professor, Department of Epidemiology University of Michigan Health System Ann Arbor, MI Teresa Chou, MPH, MS, RN, CIC Manager, Epidemiology and Infection Prevention and Control Advocate Illinois Masonic Medical Center Chicago, IL William E. Coll, MPUB, AFF, BA, LP, LEHS Program Manager—Infection Preventionist 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 Infection Control Coordinator 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 Epidemiology and Infection Prevention Northwestern Medicine Chicago, IL 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 Infection Preventionist National Jewish Health Denver, CO Janet Nau Franck RN, MBA, CIC Infection Preventionist / Consultant Chicago, IL ix Candace Friedman, MPH, CIC Project Manager/Office of Clinical Safety University of Michigan Health System Ann Arbor, Michigan Darragh Halpenny, MB BCh BAO, MRCPI, FFRRCSI Department of Radiology, Tallaght Hospital Dublin, Ireland Donald E. Fry, MD Adjunct Professor of Surgery Northwestern University Feinberg School of Medicine Chicago, IL Nancy G. Harless, BSN, MPH, CIC Infection Prevention Practitioner CaroMont Regional Medical Center Gastonia, NC Bruce Gamage, RN, BSN, CIC IC Consultant BC Centre for Disease Control Vancouver, British Columbia, Canada Patricia L. Harris MSN, RN, CIC Nurse Manager Department of Veterans Affairs Veterans Affairs Pittsburgh Healthcare System Pittsburgh, PA Sylvia Garcia-Houchins, RN, MBA, CIC Director, Infection Control Program University of Chicago Medical Center Chicago, IL Jennifer A. Harte, DDS, MS Colonel (ret) USAF, DC Dental Infection Prevention and Control Consultant Northville, MI Karen S. Geismar, MS, RD, LD, CNSC Lecturer, Department of Nutrition and Food Sciences Texas A&M University College Station, TX Janet Hass, PhD, RN, CIC Director of Infection Prevention & Control Westchester Medical Center New York, NY Joan Godich, BSN, RN Nurse Consultant Walter Reed National Military Medical Center Bethesda, MD Ann Henry, RN, MA, CIC Senior Infection Control Coordinator Blount Memorial Hospital Maryville, TN Angella M. Goetz, RN, MNEd, CIC Senior Consultant Special Pathogens Laboratory Pittsburgh, PA Carolyn T. A. Herzig, MS Project Director, Columbia University School of Nursing New York, NY Linda Goss, BS, MSN, APRN-NP, BC, CIC, COHN-S Infection Preventionist Norton Brownsboro Hospital Infectious Disease Nurse Practitioner Norton Infectious Disease Specialists Louisville, KY Elicia A. Greene, RN, MSN, CIC, CPHQ Assistant Chief, IC Central Texas Veterans Health Care System Temple, TX Marguerite Gribogiannis, BS, MPA, CIC Infection Control Practitioner Advocate Lutheran General Hospital Park Ridge, IL Patti Grota, PhD, RN, CNS-M-S, CIC Assistant Professor Schreiner University Kerrville, TX x Kimberly M. Hinckley, RN, BSN, CIC Senior Infection Control Coordinator 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 APIC Text of Infection Control and Epidemiology Pamela Iwamoto, MSN, RN, CIC Sr. RN Case Manager University of New Mexico College of Nursing Infection Preventionist Consultant University of New Mexico Medical Group Albuquerque, NM Julie Jefferson, RN, MPH, CIC Director, Epidemiology 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 San Antonio, TX 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 Louisville, KY 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 Infection Control Coordinator 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 Chicago, IL Jan Lienau, BSN, RN, CIC Infection Preventionist 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 San Antonio, TX Nedra D. Marion, RN, BSN, MPA, CIC Manager, Department of Infection Control and Epidemiology 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 San Antonio, TX xi 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 Infection Control Practitioner 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 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 Epidemiology 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 Gloria Morrell, RN, MS, MSN, CIC Nurse Consultant Centers for Disease Control and Prevention Atlanta, GA Belinda Ostrowsky, MD, MPH Director of Antimicrobial Stewardship Associate Professor of Medicine Montefiore Medical Center Bronx, NY Linda M. Mundy, MD, PhD Director, Worldwide Epidemiology Research and Development, GlaxoSmithKline Collegeville, PA William J. Pate, BS, MPH, DPH Safety Manager, Environment of Care University Health System San Antonio, TX Rebecca J. Murphy, RN, MSN, CNOR Perioperative Services Outcomes Manager Central DuPage Hospital Winfield, IL 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 San Antonio, TX 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 xii 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 APIC Text of Infection Control and Epidemiology 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 Louisville, KY 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 Jeanne Pfeiffer, DNP, MPH, RN, CIC Clinical Assistant (*Associate) Professor University of Minnesota School of Nursing Minneapolis, MN Howard G. Rush, DVM, MS, DACLAM Associate Professor Unit for Laboratory Animal Medicine The University of Michigan Ann Arbor, MI Monika Pogorzelska-Maziarz, PhD, MPH Associate Research Scientist Columbia University School of Nursing New York, NY William A. Rutala, PhD, MPH Department of Hospital Epidemiology, University of North Carolina Health Care Division of Infectious Diseases, UNC School of Medicine Chapel Hill, NC 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 Keith St. John, MS, MT(ASCP), CIC Director, Clinical Epidemiology 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 San Antonio, TX Justin Smyer, MLS(ASCP)CM, MPH, CIC Infection Control Practitioner University Hospital East Department of Clinical Epidemiology The Ohio State University Wexler Medical Center Columbus, OH xiii Barbara M. Soule, RN, MPA, CIC, FSHEA Practice Leader, Infection Prevention Services Joint Commission Resources Oak Brook, IL Valerie Sparks, BSN, CIC Infection Control Coordinator 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 San Antonio, TX 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 Chicago, IL William C. Torreggiani, MB BCh BAO, MRCPI, FFRRCSI, FRCR Department of Radiology Tallaght Hospital Dublin, Ireland xiv S. Samantha M. Tweeten, PhD, MPH Epidemiologist Epidemiology & Immunization Services Branch Health and Human Services Agency County of San Diego San Diego, CA Amanda Valyko, MPH, CIC Infection Control Practitioner Infection Control & Epidemiology University of Michigan Health System Ann Arbor, MI Brian Walsea, MPH, CIC Infection Control Practitioner Sinai Health System Chicago, IL Tyler E. Warkentien, MD, FACP Infectious Disease Department Walter Reed National Military Medical Center Bethesda, MD David J. Weber, MD, MPH Department of Hospital Epidemiology, University of North Carolina Health Care Division of Infectious Diseases, UNC School of Medicine Chapel Hill, NC Joan Weber, RN, BSN, CIC Infection Control Coordinator Shriners Hospitals for Children-Boston Boston, MA Kelly L. West, MS, RN, CIC Infection Preventionist Epidemiology 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 Epidemiology Program Assistant Director of Epidemiology and Biostatistics University of Louisville School of Medicine Division of Infectious Diseases Clinical and Translational Research Support Center Louisville, KY APIC Text of Infection Control and Epidemiology Tiffany Wiksten, BSN, RN Infection Prevention Practitioner Advocate Christ Medical Center and Advocate Children’s Hospital, Oak Lawn Oak Lawn, IL Lynette Boland, RNC, CIC Infection Preventionist Kosiar Children’s Hospital Louisville, KY Randall D. Wolcott, MD Founder and President Southwest Regional Wound Care Center Lubbock, TX Judie Bringhurst, RN, MSN, CIC Ambulatory Care Infection Preventionist/Safety Compliance Officer University of North Carolina Health System Chapel Hill, NC Carole Yeung, RN, CIC Infection Prevention Baptist Home Health Network Little Rock, AR Tania Bubb, RN, MS, CIC Infection Prevention and Control Practitioner NYU Langone Medical Center Mount Vernon, NY Martha Young, MS, BS, CSPDT Consultant SAVVY Sterilization Solutions Woodbury, MN Amelia Bumsted, BA, BS, RN, CRRN, CIC Infection Control Coordinator Marianjoy Rehabilitation Hospital Wheaton, IL John Anthony Zaia, MD Professor and Chair, Department of Virology Beckman Research Institute, City of Hope Medical Center Duarte, CA Jose Cadena Zuluaga, MD Infectious Diseases South Texas Veterans Healthcare Administration/University Health Science Center San Antonio, TX 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 Epidemiology Coordinator Sherman Hospital Elgin, IL Ruth Belflower, MPH, RN Infection Preventionist 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 Infection Preventionist Greenville Health System Greenville, SC 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 Infection Preventionist Carmichael, CA Gwen Cerkowniak, RN, BSN, CIC Provincial Infection Control Coordinator Saskatoon Health Region Saskatoon, Saskatchewan, Canada Michael Cloughessy, MS, BSEH, REHS, CIC Senior Infection Control Practitioner Cincinnati Children’s Hospital Cincinnati, OH Dorthea Davis, RPN Infection Control Officer Selkirk Mental Health Centre Selkirk, Manitoba, Canada xv Kim Delahanty, BSN, MBA/HCM, CIC Administrative Director UCSD Health System San Diego, CA Patti Grota, PhD, RN, CNS-M-S, CIC Assistant Professor Schreiner University Kerrville, TX Gemma Downham, MPH, CIC Infection Prevention Epidemiologist AtlantiCare Regional Medical Center Pomona, NJ Deborah Harkness, RegN., MScN Infection Prevention and Control Practitioner Northumberland Hills Hospital Cobourg, Ontario, Canada Brenda Ehlert, MT(ASCP), CIC Infection Prevention Coordinator Affinity Health System Oshkosh, WI Eddie Hedrick, BS, MT(ASCP), CIC Emerging Infections Coordinator Missouri Dept of Health & Senior Services Columbia, MO Julia Frith, RN, MSN, CIC Infection Prevention Kosair Children’s Hospital Louisville, KY Crystal Heishman, BSN, RN, CIC, ONC Infection Preventionist University of Louisville Healthcare Louisville, KY Therese Flood, RN, BSN Infection Control Nurse Baptist Hospital East Louisville, KY Tricia Herridge, BSC, BEH, CPHI(C) Public Health Inspector Alberta Health Services Camrose, Alberta, Canada Marie Fornof, RN, BSN, CIC Infection Preventionist National Jewish Health Highlands, CO Sally Hess, MPH Manager Infection Prevention Fletcher Allen Health Care Burlington, VT Gail Fraine, RN, MMHC, BSN, CIC Director Infection Prevention Saint Thomas Midtown Hospital (formerly Baptist Hospital) Nashville, TN Steve Hilley, RN Infection Prevention Coordinator Yampa Valley Medical Center Steamboat Springs, CO Melissa Fugate, BSN, RN, CIC Infection Control Coordinator Baptist Health Louisville Louisville, KY Kimberly Hinckley, RN, BSN, CIC Sr. Infection Control Coordinator Roswell Park Cancer Institute Buffalo, NY Kate Gase, MPH, CIC Hospital Acquired Infection Reporting Program Regional Representative Memorial Sloan Kettering Cancer Center New York, NY Jill Holdsworth, MS, CIC, EMT-B Infection Control Practitioner INOVA Mount Vernon Hospital Alexandria, VA Kasey Gambeta, BScN, RN, MN Infection Control Professional St. Michael’s Hospital Toronto, Ontario, Canada Patricia Gould, RN, BSN Manager, Infection Control Jewish Hospital Louisville, KY xvi Sandra Hyman, RN, MPA, CIC Infection Prevention Specialist New York Presbyterian - Columbia University Medical Center New Rochelle, NY Sharon Jacobs, RN, MS, CIC Infection Preventionist Bridgeville, PA Debra Johnson, BSN, RN, CIC Infection Prevention Nurse Stanford Hospital & Clinics Stanford, CA APIC Text of Infection Control and Epidemiology Marie Kassai, RN, BSN, MPH, CIC Infection Prevention Consultant MRK Consulting, LLC West Paterson, NJ Shirley McDonald, ART, CIC IPAC Resource Expert Public Health Ontario Bath, Ontario, Canada Irena Kenneley, PhD, APRN-BC, CIC Assistant Professor Case Western Reserve University Cleveland, OH Jacquelyn McKnight, LPN, RPN, CFCN, NACICP Council, College of Nurses of Ontario, VP IB/SIG RPNAO Elliot Lake Foot Care Elliot Lake, Ontario, Canada Anjum Khan, MBBS, MSc Infection Preventionist St. Michael’s Hospital Toronto, Ontario, Canada Carol McLay, DrPH, BSN, RN, CIC Infection Prevention Consultant Lexington, KY 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 Caroline Meguerditchian Infection Control Coordinator The Perley and Rideau Veterans’ Health Centre Ottawa, Ontario, Canada Elizabeth Monsees, RN, MSN, MBA, CIC Infection Control Practitioner 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 Infection Preventionist UC San Diego Healthcare Systems San Diego, CA Pam Nolting, RN, MSN, CIC Infection Control Professional University of Louisville Hospital Louisville, KY 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 Ann Marie Pettis, RN, BSN, CIC Director University of Rochester Medical Center Rochester, NY William Wagner, ScD, CHCM, CHSP, CHEP Vice President, Quality Compliance TSIG Consulting Marietta, GA Michael Anne Preas, RN, CIC Infection Control Practitioner University of Maryland Medical Center Baltimore, MD Tonya Wagner, BSN Elms Eye Center Summerville, SC 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 Leslie Walker-Rice, BSCN Infection Prevention and Control Nurse Kateri Memorial Hospital Center Kahnawake, Quebec, Canada Kathy Ward, RN, BSN, MPH, CIC Infection Control Practitioner Roper Hospital Charleston, SC Teresa Rybacki-Anisko, RN, BSC, CIC Infection Control Professional Mississauga, Ontario, Canada David Weber, MD, MPH, MHA Professor of Medicine, Pediatrics, and Epidemiology University of North Carolina – Chapel Hill Chapel Hill, NC Deanna Samms, BS, MA, CIC Infection Preventionist Charleston Area Medical Center Charleston, WV Maria Whitaker, MT, CIC Infection Preventionist Cortland Regional Medical Center Cortland, NY Steve Schweon, RN, MPH, MSN, CIC, HEN Infection Prevention Consultant Saylorsburg, Pennsylvania Sharon Winefordner, RN, BSN, CIC Infection Preventionist Charleston Area Medical Center Charleston, WV 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 San Antonio, TX Carole VanAntwerpen, RN, BSN, CIC Consultant, Infection Prevention and Epidemiology Clifton Park, NY xviii 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 Infection Preventionist Kosair Children’s Hospital Georgetown, ID APIC Text of Infection Control and Epidemiology PRODUCTION STAFF Managing Editor Thomas Weaver, DMD Director, Professional Practice Association for Professionals in Infection Control and Epidemiology Washington, DC Editorial Assistance and Project Support Jim Angelo Director, Publishing Association for Professionals in Infection Control and Epidemiology Washington, DC Anna Conger Associate Director, Publishing Association for Professionals in Infection Control and Epidemiology Washington, DC Christina James Practice Resources Coordinator Association for Professionals in Infection Control and Epidemiology Washington, DC Additional assistance was provided by the following APIC staff members: Dave Bentley Marketing Manager Association for Professionals in Infection Control and Epidemiology Washington, DC Janiene Bohannon Associate Director, Communications Association for Professionals in Infection Control and Epidemiology Washington, DC Correen Dingle Marketing Manager Association for Professionals in Infection Control and Epidemiology Washington, DC Caroline Fuchs, CAE Senior Director, Marketing Association for Professionals in Infection Control and Epidemiology Washington, DC Elizabeth Garman Senior Director, Communications Association for Professionals in Infection Control and Epidemiology Washington, DC Kathryn Hitchcock Project Manager Association for Professionals in Infection Control and Epidemiology Washington, DC Lynn Schneider Senior Director, Human Resources Association for Professionals in Infection Control and Epidemiology Washington, DC Cover Design Project Design Company Washington, DC Book Design and Layout Maryland Comp Laurel, MD Printing AGS, An RR Donnelley Company White Plains, MD xix 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 2014. 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 Epidemiology of America guidelines committee, received grant funding from Clorox Healthcare, is on the speaker bureau for Sanofi Pasteur. xxi