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Definition of Infection for Surveillance in LTCFs (Long Term Care Facilities) (Am J Infect Control 1991: 1)

Skin and soft tissue infections
           A. Cellulitis/soft tissue/wound infection —
                 pus* at a wound, skin or soft tissue
                d or four of the following:

          (1) fever (>38C) or worsening mental/ functional status; and/or
               at the affected site, the presence of new or increasing
          (2) heat,
          (3) redness,
          (4) swelling,
          (5) tenderness or pain,
          (6) serous drainage.
B. Fungal skin infection — both
          (1) a maculopapular rash and
          (2) either physician diagnosis or laboratory confirmation.
C. Herpes simplex and herpes zoster infection — both
          (1) vesicular* rash and
          (2) either physician diagnosis or laboratory confirmation.
D. Scabies — both
          (1) maculopapular and/or itching rash and
          (2) either physician diagnosis or laboratory confirmation.
“Pus” is a creamy, viscous, pale yellow or yellow-green fluid exudate that is the result of liquefaction necrosis. Bacterial infection is its most common cause. Pus in a cavity surrounded by inflamed tissue is usually local and generally caused by Staphylococcal infection. Healing can usually begin when the abscess drains or is incised.
“Maculopapular” small pigmented or spotty solid raised abnormal skin lesions less than 1cm. in diameter that appear separate or different from the surrounding skin.
“Vesicular” pertains to a blister-like condition.
Impetigo is a streptococcal and/or staphylococcal infection of the skin beginning as focal erythemas (redness or inflammation) and progressing to pruritic vesicles (small thin-walled blister lesions containing clear fluid), erosions and dries into honey-colored or golden crusts. Lesions usually form on the face and spread to other areas. The exudate is highly contagious. Local care with soap and water or antimicrobial cream will effectively eradicate the condition.
Clients with symptoms of contagious skin infections should be requested to clear the condition before a tattoo or piercing is done. Always refer clients to local health care professionals for evaluation.

We understand today that the risk for infection varies greatly depending on the individual patient's risk factors. p910
Although this observation is unproved, the greatest risk factor for post operative infection appears to be the patient's physical status. p470
Adequate protein reserves are necessary for normal body function.
Maintenance of weight as contrasted to weight loss implicates weight loss as a risk factor.
Immuno competent patients experience significantly fewer septic conditions.
Younger patients as a group have a better overall health status than adults and have overall lower infection rates.
Higher wound infection rates are also observed in patients older than 55 years of age.
Hospital length of stay doubles the risk per week of stay.
Razor shaving as compared to depilatory or clipping is associated with higher infection rates.
Preshowering or bathing with antiseptic detergent has not been conclusive among studies.
The presence of an active remote infection greatly influences the development of post operative wound infection.
Operative procedures longer than one hour are associated with increased infections.
from: Infectious Diseases. Compiled