Guidelines and Recommendations

Part of CDC's work is the development and dissemination of public health guidance based on the best available information. CDC is committed to reviewing and updating these guidance documents to ensure that they provide up-to-date, practical, and effective public health recommendations.

Healthcare Infection Control Practices Advisory Committee (HICPAC) is charged with providing advice and guidance to the Secretary, Department of Health and Human Services; the Director, CDC; and the Director, National Center for Emerging and Zoonotic Infectious Diseases (NCEZID), regarding the practice of hospital infection control and strategies for surveillance, prevention, and control of healthcare-associated infections (e.g., nosocomial infections), antimicrobial resistance, and related events in settings where healthcare is provided, including hospitals, ambulatory and long-term care facilities, and home health agencies. The committee shall also advise CDC on periodic updating of existing guidelines, development of new guidelines, guideline evaluation, and other policy statements regarding prevention of healthcare-associated infections and healthcare-related conditions.

For more information see Updating the Guideline Methodology of the Healthcare Infection Control Practices Advisory Committee (HICPAC) [PDF - 188 KB]

General Guidelines

Top CDC Recommendations to Prevent Healthcare-Associated Infections

Preventing Healthcare-associated Infections [PDF - 2.28 MB]
Council of State and Territorial Epidemiologists Workshop June 7, 2009

2008 Guideline for Disinfection, and Sterilization in Healthcare Facilities presents evidence-based recommendations on the preferred methods for cleaning, disinfection, and sterilization of patient-care medical devices and for cleaning and disinfecting the healthcare environment. In addition to updated recommendations, new topics are also addressed in this guideline.
Guideline for Disinfection and Sterilization in Healthcare Facilities, 2008 [PDF - 948 KB].

Guidelines for Environmental Infection Control in Healthcare Facilities June 6, 2003 / 52(RR10);1-42 The Guidelines for Environmental Infection Control in Healthcare Facilities is a compilation of recommendations for the prevention and control of infectious diseases that are associated with healthcare environments.
Available for download [PDF - 1.4 MB]

Guidelines for Hand Hygiene in Healthcare Settings
Recent developments in the field have stimulated a review of the scientific data regarding hand hygiene and the development of new guidelines designed to improve hand hygiene practices in healthcare facilities.
Guidelines for Hand Hygiene in Healthcare Settings Published 2002 [PDF - 359 KB] October 25, 2002 / Vol. 51 / No. RR-16

2007 Guideline for Isolation Precautions: Preventing Transmission of Infectious Agents in Healthcare Settings This document is intended for use by infection control staff, healthcare epidemiologists, healthcare administrators, nurses, other healthcare providers, and persons responsible for developing, implementing, and evaluating infection control programs for healthcare settings across the continuum of care.
Complete PDF version available for download Guideline for Isolation Precautions: Preventing Transmission of Infectious Agents in Healthcare Settings 2007 [PDF - 3.80 MB]

Guidance on Public Reporting of Healthcare-associated Infections: Recommendations HICPAC has developed this guidance document based on established principles for public health and HAI reporting systems. This document is intended to assist policymakers, program planners, consumer advocacy organizations, and others tasked with designing and implementing public reporting systems for HAIs.
Available for download [PDF - 150 KB]

Interim Guidance for Managing Patients with Suspected Viral Hemorrhagic Fever in U.S. Hospitals [PDF - 80 KB] May 2005. This document updates recommendations (MMWR 1995; 44 (25) ;475-9) for managing patients with suspected viral hemorrhagic fever (VHF) who are admitted to U.S. hospitals.

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Device-associated Infection Prevention Guidelines

Guideline for Prevention of Catheter-associated Urinary Tract Infections 2009
In addition to updating the previous 1981 guideline, this revised guideline reviews the available evidence on CAUTI prevention for patients requiring chronic indwelling catheters and individuals who can be managed with alternative methods of urinary drainage (e.g., intermittent catheterization). The revised guideline also includes specific recommendations for implementation, performance measurement, and surveillance.

• Available for download: Guideline for Prevention of CAUTI, 2009 [PDF - 407 KB]
  Appendices - Guideline for Prevention of CAUTI, 2009 [PDF - 4.41 MB]
• CAUTI Guideline Fast Facts
• Watch this Podcast: Dr. Sanjay Saint discusses Catheter-associated UTIs

Guidelines for the Prevention of Intravascular Catheter-Related Infections, 2002 August 9, 2002 / 51(RR10);1-26

Guidelines for the Prevention of Intravascular Catheter-Related Infections, 2011
This report provides Healthcare practitioners with background information and specific recommendations to reduce the incidence of intravascular catheter-related bloodstream infections (CRBSI).

• Available for download: Guideline for the Prevention of Intravascular CRBSI, 2011 [PDF - 1.05 MB]

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Procedure-associated Infection Prevention Guidelines

Guideline for the Prevention of Surgical Site Infection, 1999 [PDF - 270 KB]
This document is primarily intended for use by surgeons, operating room nurses, postoperative inpatient and clinic nurses, infection control professionals, anesthesiologists, healthcare epidemiologists, and other personnel directly responsible for the prevention of nosocomial infections.

Guideline for Preventing Healthcare-Associated Pneumonia , 2003 This report updates, expands, and replaces the previously published CDC "Guideline for Prevention of Nosocomial Pneumonia". The new guidelines are designed to reduce the incidence of healthcare-associated pneumonia and other severe, acute lower respiratory tract infections in acute-care hospitals and in other Healthcare settings (e.g., ambulatory and long-term care institutions) and other facilities where healthcare is provided.
Download the complete guideline [PDF - 1.17 MB]

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Drug-resistant Organisms

Guidelines for Developing an Institutional Program to Enhance Antimicrobial Stewardship

Management of Multidrug-Resistant Organisms In Healthcare Settings, 2006 The prevention and control of MDROs is a national priority - one that requires that all healthcare facilities and agencies assume responsibility. The following recommendations are provided to guide the implementation of strategies and practices to prevent the transmission of MRSA, VRE, and other MDROs.
Available for download [PDF - 233 KB]

Guidance for Control of Infections with Carbapenem-Resistant or Carbapenemase-Producing Enterobacteriaceae in Acute Care Facilities MMWR March 20, 2009 / 58(10);256-260
In light of the clinical and infection control challenges posed by CRE and advances in the ability to detect these pathogens, CDC and HICPAC have developed new guidance for CRE infection prevention and control in an effort to limit the further emergence of these organisms. These recommendations are based on strategies outlined in the 2006 HICPAC guidelines for management of multidrug-resistant organisms in Healthcare settings. Available for download [PDF 1.18 MB]

• Public Health update of Carbapenem-Resistant Enterobacteriaceae (CRE) producing metallo-beta-lactamases (NDM, VIM, IMP) in the U.S. reported to CDC

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Healthcare Personnel

Influenza Vaccination of Health-Care Personnel, 2006 Please note: An erratum has been published for this article. View the erratum. MMWR February, 2006/55(RR02);1-16
HICPAC and ACIP recommend that all Healthcare personnel be vaccinated annually against influenza. Facilities that employ HCP are strongly encouraged to provide vaccine to their staff by using evidence-based approaches that maximize vaccination rates.
Available for download [PDF - 628 KB]

Guideline for Infection Control in Hospital Personnel 1998 PDF (1.04 MB/ 66 pages)
This guideline updates and replaces the previous edition of the Centers for Disease Control and Prevention (CDC) "Guideline for Infection Control in Hospital Personnel," published in 1983. The revised guideline, designed to provide methods for reducing the transmission of infections from patients to healthcare personnel and from personnel to patients, also provides an overview of the evidence for recommendations considered prudent by consensus of the Hospital Infection Control Practices Advisory Committee members.

Recommendations for Using Smallpox Vaccine in a Pre-Event Vaccination Program April 4, 2003 / 52(RR07);1-16

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Protecting Healthcare Personnel from HIV

• Updated U.S. Public Health Service Guidelines for the Management of Occupational Exposures to HIV and Recommendations for Post-Exposure Prophylaxis MMWR September 30, 2005 / 54(RR09);1-17
• Exposure to Blood What Healthcare Personnel Need to Know [PDF - 330 KB] July 2003
• Updated U.S. Public Health Service Guidelines for the Management of Occupational Exposures to HBV, HCV, and HIV and Recommendations for Postexposure Prophylaxis MMWR June 29, 2001 / 50(RR11);1-42
• Appendix A. Practice Recommendations for Health-Care Facilities Implementing the U.S. Public Health Service Guidelines for Management of Occupational Exposures to Bloodborne Pathogens MMWR June 29, 2001 / 50(RR11);43-44
• Appendix B. Management of Occupational Blood Exposures MMWR June 29, 2001 / 50(RR11);45-46
• Appendix C. Basic and Expanded HIV Postexposure Prophylaxis Regimens MMWR June 29, 2001 / 50(RR11);47-52
• Preventing Needlestick Injuries in Healthcare Settings NIOSH 1999
• Guidelines for Infection Control in Healthcare Personnel, 1998 [PDF - 1.04 MB]
• Evaluation of Safety Devices for Preventing Percutaneous Injuries Among Healthcare Workers During Phlebotomy Procedures 1993-1995. MMWR 1997
• Evaluation of Blunt Suture Needles in Preventing Percutaneous Injuries Among Healthcare Workers During Gynecologic Surgical Procedures March 1993-June 1994. MMWR 1997
• Case-control study of HIV seroconversion in Healthcare worker after percutaneous exposure to HIV-infected blood MMWR 1995
• USPHS/IDSA Guidelines for the prevention of opportunistic infections in persons infected with human immunodeficiency virus: a summary. MMWR 1995
• Guidelines for preventing the transmission of HIV through transplantation of human tissue and organs. MMWR 1994
• Use of vaccines and immune globulin in persons with altered immunocompetence (Recommendations of the ACIP). MMWR 1993 Recommendations for HIV testing services for inpatients and outpatients in acute-care hospital settings. MMWR 1993
• Recommendations for Preventing Transmission of Human Immunodeficiency Virus and Hepatitis B Virus to Patients During Exposure-Prone Invasive Procedures MMWR July 12, 1991 / 40(RR08)
• Guidelines for Prevention of Transmission of Human Immunodeficiency Virus and Hepatitis B Virus to Health-Care and Public-Safety Workers A Response to P.L. 100-607 The Health Omnibus Programs Extension Act of 1988 MMWR June 23, 1989 / 38(S-6);3-37
• CDC's Perspectives in Disease Prevention and Health Promotion Update: Universal Precautions for Prevention of Transmission of Human Immunodeficiency Virus, Hepatitis B Virus, and Other Bloodborne Pathogens in Health-Care Settings - MMWR June 24, 1988 / 37(24);377-388
• CDC Recommendations for prevention of HIV transmission in Healthcare settings MMWR August 21, 1987 / 36(SU02);001

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