Surveillance of skin and soft tissue infection
Skin and Soft Tissue infection (SST) is one of the Major and Specific types of HAI and it consist of group of specific infections and we have to be aware that surveillance criteria is a well-defined criteria for surveillance purposes and have to be clearly present for recording the specific site infection. The issue of SST infection is mainly misinterpreted with other kinds of infection like Surgical Site Infection even each one has its own criteria to be well defined and differentiated from others and was clearly discussed in the NHSN surveillance guidelines, in the upcoming two parts we will discuss the criteria need to properly make a good surveillance of skin and soft tissue infection
Breast abscess or mastitis
A breast abscess or mastitis has to be diagnosed when one of the following criteria is present:
1. Patient has a positive culture of affected breast tissue or fluid obtained by invasive procedure.
2. Patient has a breast abscess or other evidence of infection seen during an invasive procedure or histopathologic examination.
3. Patient has fever (>38°C) and local inflammation of the breast
Documented physician diagnosis has to be written
Burn infections must meet at least one of the following criteria:
1. Patient has a change in burn wound appearance e.g. rapid eschar separation or violaceous discoloration of the eschar, or edema at wound margin and histologic examination of burn biopsy shows invasion of organisms into adjacent viable tissue.
2. Patient has a change in burn wound appearance e.g. rapid eschar separation, or violaceous discoloration of the eschar, or edema at wound margin Plus at least 1 of the following:
A. organisms cultured from blood in the absence of other identifiable infection
B. isolation of herpes simplex virus, or visualization of viral particles by EM in biopsies or lesion scrapings.
3. Patient with a burn has at least 2 of the following signs or symptoms: fever or hypothermia , oliguria,hypotension, hyperglycemia at previously tolerated level of dietary carbohydrate, or mental confusion and at least 1 of the following:
A. histologic examination of burn biopsy shows invasion of organisms into adjacent viable tissue
B. organisms cultured from blood
C. isolation of herpes simplex virus,or seeing of viral particles by EM in biopsies or lesion scrapings.
Circumcision infection in a newborn (≤30 days old) must have at least 1 of the following criteria:
1. Newborn has purulent drainage from circumcision site.
2. Newborn has at least 1 of the following signs or symptoms with no other recognized cause at circumcision site: erythema, swelling, or tenderness and pathogen cultured from circumcision site.
3. Newborn has at least 1 of the following signs or symptoms with no other recognized cause at circumcision site: erythema, swelling, or tenderness and skin contaminant (i.e., diphtheroids [Corynebacterium spp], Bacillus, group streptococci, Aerococcus spp, Micrococcus spp) is cultured from circumcision site and physician diagnosis of infection or physician institutes appropriate therapy.
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