Infections by Organ System

Despite advances in medical, surgical, and critical care interventions, infective endocarditis remains a disease that is associated with considerable morbidity and mortality. The continuing evolution of antimicrobial resistance among common pathogens that cause infective endocarditis creates additional therapeutic issues for physicians to manage in this potentially life-threatening illness.

Encephalitis is defined by the presence of an inflammatory process of the brain in association with clinical evidence of neurologic dysfunction. Of the pathogens reported to cause encephalitis, the majority are viruses. However, despite extensive testing, the etiology of encephalitis remains unknown in most patients. Another major challenge for patients with encephalitis is to determine the relevance of an infectious agent identified outside of the CNS; these agents may play a role in the neurologic manifestations of illness but not necessarily by directly invading the CNS. Link to full text guideline 

*Every 12 to 18 months following publication, IDSA reviews its guidelines to determine whether an update is required.  This guideline was last reviewed and deemed current as of 07/2011. 

This guideline is designed to improve the diagnosis and management of Clostridium difficile infection (CDI) in adult patients. A case of CDI is defined by the presence of symptoms (usually diarrhea) and either a stool test positive for C. difficile toxins or toxigenic C. difficile, or colonoscopic or histopathologic findings revealing pseudomembranous colitis. In addition to diagnosis and management, recommended methods of infection control and environmental management of the pathogen are presented. The recommendations are based on the best available evidence and practices, as determined by a joint Expert Panel appointed by SHEA and the Infectious Diseases Society of America (IDSA) (the SHEA-IDSA Expert Panel). The use of these guidelines can be impacted by the size of the institution and the resources, both financial and laboratory, available in the particular clinical setting. Link to full text guideline 

*Projected publication, Fall 2013  

The widening array of recognized enteric pathogens and the increasing demand for cost-containment sharpen the need for careful clinical and public health guidelines based on the best evidence currently available. Adequate fluid and electrolyte replacement and maintenance are key to managing diarrheal illnesses. Thorough clinical and epidemiological evaluation must define the severity and type of illness, exposures, and whether the patient is immunocompromised, in order to direct the performance of selective diagnostic cultures, toxin testing, parasite studies, and the administration of antimicrobial therapy. Link to full text guideline 

*Projected Publication, Spring 2013 

Intended for use by physicians, these recommendations suggest preferred approaches to the diagnostic, therapeutic, and preventive aspects of care. They are intended to be flexible, in contrast to standards of care, which are inflexible policies to be followed in every case. Specific recommendations are based on relevant published information. To more fully characterize the quality of evidence supporting recommendations, the Practice Guidelines Committee of the AASLD requires a Class (reflecting benefit versus risk) and Level (assessing strength or certainty) of Evidence to be assigned and reported with each recommendation (Table 1, adapted from the American College of Cardiology and the American Heart Association Practice Guidelines). Link to full text guideline 

The purpose of this guideline is to provide recommendations for diagnosis and treatment of asymptomatic bacteriuria in adult populations >18 years of age. The recommendations were developed on the basis of a review of published evidence, with the strength of the recommendation and quality of the evidence graded using previously described Infectious Diseases Society of America (IDSA) criteria. Link to full text guideline 

*Every 12 to 18 months following publication, IDSA reviews its guidelines to determine whether an update is required. This guideline was last reviewed and deemed current as of 03/2011. 

Guidelines for the diagnosis, prevention, and management of persons with catheter‐associated urinary tract infection (CA‐UTI), both symptomatic and asymptomatic, were prepared by an Expert Panel of the Infectious Diseases Society of America. The evidence‐based guidelines encompass diagnostic criteria, strategies to reduce the risk of CA‐UTIs, strategies that have not been found to reduce the incidence of urinary infections, and management strategies for patients with catheter‐associated asymptomatic bacteriuria or symptomatic urinary tract infection. Link to full text guideline 

*Every 12 to 18 months following publication, IDSA reviews its guidelines to determine whether an update is required. This guideline was last reviewed and deemed current as of 03/2012. 

Panel of International Experts was convened by the Infectious Diseases Society of America (IDSA) in collaboration with the European Society for Microbiology and Infectious Diseases (ESCMID) to update the 1999 Uncomplicated Urinary Tract Infection Guidelines by the IDSA. Co-sponsoring organizations include the American Congress of Obstetricians and Gynecologists, American Urological Association, Association of Medical Microbiology and Infectious Diseases–Canada, and the Society for Academic Emergency Medicine. The focus of this work is treatment of women with acute uncomplicated cystitis and pyelonephritis, diagnoses limited in these guidelines to premenopausal, non-pregnant women with no known urological abnormalities or co-morbidities. Link to full text guideline 

*Every 12 to 18 months following publication, IDSA reviews its guidelines to determine whether an update is required. This guideline was last reviewed and deemed current as of 02/2012.  

Evidence‐based guidelines for managing patients with intra‐abdominal infection were prepared by an Expert Panel of the Surgical Infection Society and the Infectious Diseases Society of America. These updated guidelines replace those previously published in 2002 and 2003. The guidelines are intended for treating patients who either have these infections or may be at risk for them. New information, based on publications from the period 2003–2008, is incorporated into this guideline document. The panel has also added recommendations for managing intra‐abdominal infection in children, particularly where such management differs from that of adults; for appendicitis in patients of all ages; and for necrotizing enterocolitis in neonates. Link to full text guideline 

*Every 12 to 18 months following publication, IDSA reviews its guidelines to determine whether an update is required.  This guideline was last reviewed and deemed current as of 01/2012.   

Since the initial 1996 American Thoracic Society (ATS) guideline on nosocomial pneumonia, a number of new developments have appeared, mandating a new evidence-based guideline for hospital-acquired pneumonia (HAP), including healthcare-associated pneumonia (HCAP) and ventilator-associated pneumonia (VAP). This document, prepared by a joint committee of the ATS and Infectious Diseases Society of America (IDSA), focuses on the epidemiology and pathogenesis of bacterial pneumonia in adults, and emphasizes modifiable risk factors for infection.

*Projected Publication, Fall 2012 

This statement is an update of the practice guideline published in 1997 and takes into account relevant research published since that time. A major substantive change is the acceptance of negative results of rapid antigen detection testing (RADT) for exclusion of acute streptococcal pharyngitis, without the previously mandated confirmation with a negative culture result. Link to full text guideline 

*Projected Publication, Spring 2012 

Foot infections in persons with diabetes are a common, complex, and costly problem. In addition to causing severe morbidities, they now account for the largest number of diabetes-related hospital bed–days and are the most common proximate, nontraumatic cause of amputations. Diabetic foot infections require careful attention and coordinated management, preferably by a multi-disciplinary foot-care team... Optimal management of diabetic foot infections can potentially reduce the incidence of infection-related morbidities, the need for and duration of hospitalization, and the incidence of major limb amputation. Link to full text guideline 

*Projected Publication, Spring 2012 

Soft-tissue infections are common, generally of mild to modest severity, and are easily treated with a variety of agents... Clinical assessment of the severity of infection is crucial, and several classification schemes and algorithms have been proposed to guide the clinician. However, most clinical assessments have been developed from either retrospective studies or from an author's own “clinical experience,” illustrating the need for prospective studies with defined measurements of severity coupled to management issues and outcomes. Link to full text guideline 

*Projected Publication, Fall 2012