SHEA Guidelines and Expert Guidance Documents

This SHEA white paper updates the 2010 SHEA guideline, following advances in interventions that reduce risk for occupational exposures and injuries, antiretroviral therapy that can now fully suppress HIV, and evidence of very low risk for transmission from HCP to patients (only 5 occurrences worldwide since 2010). This white paper provides recommendations regarding Category III/exposure-prone procedures. It details factors that contribute to the pathogenesis and transmission risk for HBV, HCV, and HIV, viral load thresholds for any restrictions on HCP practice, categorization of healthcare-associated procedures according to level of risk for bloodborne pathogen transmission, and responsibilities of healthcare organizations, including academic institutions, professional schools, hospitals, and other healthcare facilities.

Authors: Henderson DK, Dembry L-M, Sifri CD, Palmore TN, Dellinger EP, Yokoe DS, Grady C, Heller T, Weber D, del Rio C, Fishman NO, Deloney VM, Lundstrom T, Babcock HM

https://doi.org/10.1017/ice.2020.458

These white papers serve as companion to CDC’s Healthcare Infection Control Practices Advisory Committee (HICPAC) Recommendations for Prevention and Control of Infections in Neonatal Intensive Care Unit Patients and provide practical, expert opinion and/or evidence-based answers to frequently asked questions on infection detection and prevention in the NICU on S. aureus, C. difficile, CLABSI, and respiratory infections.

Authors: Akinboyo IC, Zangwill KM, Berg WM, Cantey JB, Huizinga B, Milstone AM

https://doi.org/10.1017/ice.2020.51

β-Lactam antibiotics are among the safest and most effective antibiotics; however, many patients report allergies to these drugs despite few having clinically significant reactions, resulting in the use of broad-spectrum antibiotics that increase the risk for antimicrobial resistance and adverse events. This review provides recommendations for the evaluation of penicillin allergies to support antimicrobial stewardship.

https://doi.org/10.1001/jama.2018.19283

Patient Resources: https://jamanetwork.com/journals/jama/fullarticle/2720729 

This SHEA expert guidance gives infection prevention and control recommendations related to hand hygiene (activities, glove use, alcohol-based hand sanitizer), reusable versus single-use devices, environmental cleaning and management, use of injection ports, barrier precautions, and vials, syringes, and IV bags.

Authors: Munoz-Price LS, Bowdle A, Johnston BL, Bearman G, Camins BC, Dellinger EP, Geisz-Everson MA, Holzmann-Pazgal G, Murthy R, Pegues D, Prielipp RC, Rubin ZA, Schaffzin J, Yokoe D, Birnbach DJ

https://doi.org/10.1017/ice.2018.303

Infection Prevention in the Operating Room Anesthesia Work Area GUIDELINES Pocket Guide

These white papers serve as companion to CDC’s Healthcare Infection Control Practices Advisory Committee (HICPAC) Recommendations for Prevention and Control of Infections in Neonatal Intensive Care Unit Patients and provide practical, expert opinion and/or evidence-based answers to frequently asked questions on infection detection and prevention in the NICU on S. aureus, C. difficile, CLABSI, and respiratory infections.

Authors: Sandora TJ, Bryant KK, Cantey JB, Elward AM, Yokoe DS, Bartlett AH

https://doi.org/10.1017/ice.2018.209

This CFF and SHEA guideline updates the 2003 Cystic Fibrosis Foundation recommendations for infection prevention and control to reduce the risk of acquisition and transmission of pathogens among people with CF.

Authors: Saiman L, Siegel JD, LiPuma JJ, Brown RF, Bryson EA, Chambers MJ, Downer VS, Fliege J, Hazle LA, Jain M, Marshall BC, O’Malley C, Pattee SR, Potter-Bynoe G, Reid S, Robinson KA, Sabadosa KA, Schmidt HJ, Tullis E, Webber J, Weber DJ

Reviewed: 8/1/2014

https://doi.org/10.1086/676882

These ASHP, SHEA, IDSA, and SIS clinical practice guidelines provide practitioners with a standardized approach to the rational, safe, and effective use of antimicrobial agents for the prevention of surgical-site infections based on available clinical evidence and emerging issues.

Authors: Bratzler D, Dellinger EP, Olsen K, Perl T, Autwaerter P, Bolon M, Fish D, Napolitano L, Sawyer R, Slain D, Steinberg J, Weinstein R

Reviewed: 2/4/2013

https://www.ashp.org/surgical-guidelines

IDSA and SHEA update to the 2010 clinical practice guideline on Clostridium difficile infection (CDI) in adults, incorporating recommendations for children (following the adult recommendations for epidemiology, diagnosis, and treatment) and significant changes in the management of CDI reflecting the evolving controversy over best methods for diagnosis. This evidence-based guideline updates recommendations regarding epidemiology, diagnosis, treatment, infection prevention, and environmental management.

Authors: McDonald LC, Gerding D, Johnson S, Bakken J, Carroll K, Coffin S, Dubberke E, Garey K, Gould C, Kelly C, Loo V, Sammons JS, Sandora T, Wilcox M

Partial Update: January 2021

https://doi.org/10.1093/cid/cix1085

This SHEA expert guidance gives general guidance to the medical community regarding HCP attire outside the operating room. In addition to the initial guidance statement, the article has 3 major components: review and interpretation of the medical literature regarding, review of hospital policies related to HCP attire, and a survey of the SHEA Research Network to assess institutional HCP attire policies and perceptions. Although the optimal choice of HCP attire for inpatient care remains undefined, the document provides recommendations on the use of white coats, neckties, footwear, the bare-below-the-elbows strategy, and laundering.

Authors: Bearman G, Bryant K, Leekha S, Mayer J, Munoz-Price LS, Murthy R, Palmore T, Rupp ME, White J

Reviewed: June 2018

https://doi.org/10.1086/675066

This SHEA expert guidance advises hospitals in when they can safely discontinue contact precautions for patients with multidrug-resistant bacteria, addressing how long hospital staff should use these safety protocols to reduce the spread of pathogens within the hospital, in most cases ranging from one to three negative cultures prior to discontinuation. The guidance also outlines the use of molecular testing in care decisions.

Authors: Banach DB, Bearman G, Barnden M, Hanrahan JA, Leekha S, Morgan DJ, Murthy R, Munoz-Price LS, Sullivan KV, Popovich KJ, Wiemken TL

https://doi.org/10.1017/ice.2017.245

Duration of Contact Precautions GUIDELINES Pocket Guide

This SHEA expert guidance document, developed as part of the SHEA/CDC Outbreak Response Training Program (ORTP), provides recommendations for incident management during infectious diseases outbreaks and how to work within an emergency response framework. The guidance’s recommendations are not pathogen-specific and are meant to apply to a range of potential infectious diseases outbreaks.

Authors: Banach DB, Johnston BL, Al-Zubeidi D, Bartlett AH, Bleasdale SC, Deloney VM, Enfield KB, Guzman-Cottrill JA, Lowe C, Ostrosky-Zeichner L, Popovich KJ, Patel PK, Ravin K, Rowe T, Shenoy ES, Stienecker R, Tosh PK, Trivedi KK

https://doi.org/10.1017/ice.2017.212

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IDSA and SHEA evidence-based guidelines for implementation and measurement of antibiotic stewardship interventions in inpatient populations including long-term care, with recommendations that address the best approaches for antibiotic stewardship programs to influence the optimal use of antibiotics.

Authors: Barlam T, Cosgrove S, Abbo L, MacDougall C, Schuetz A, Septimus E, Srinivasan A, Dellit T, Falck-Ytter Y, Fishman N, Hamilton C, Jenkins T, Lipsett P, Malani P, May L, Moran G, Neuhauser M, Newland J, Ohl C, Samore M, Seo S, Trivedi K

https://doi.org/10.1093/cid/ciw118