With advances in technology and medical science children with previously untreatable and often
fatal conditions such as congenital heart disease extreme prematurity and pediatric
malignancy are living longer. While this is a tremendous achievement pediatric providers are
now more commonly facing challenges in these medical complex children both as a consequence of
their underlying disease and the delivery of medical care. The term healthcare-associated
infections (HAIs) encompass both infections that occur in the hospital and those that occur as
a consequence of healthcare exposure and medical complexity in the outpatient setting. HAIs are
associated with substantial morbidity and mortality for the individual patient as well as
seriously taxing the healthcare system as a whole. In studies from the early 2000s over 11% of
all children in pediatric intensive care units develop HAIs and this figure increases
substantially if neonatal intensive care units areconsidered. While progress has been made in
decreasing the rates of HAI in the hospital these infections remain a major burden on the
medical system. In a study published in 2013 the annual estimated costs of the five most
common HAIs in the United States totaled $9.8 billion. An estimated 648 000 patients developed
HAIs in hospitals within the US in 2011 and children with healthcare-associated bloodstream
infection have a greater than three-fold increased risk of death. While a number of texts
discuss HAIs in the broader context of infectious diseases or pediatric infectious diseases
(such as Mandell's Principles and Practice of Infectious Diseases or Long and Pickering's
Principles and Practice of Pediatric Infectious Diseases) no single text specifically focuses
on the epidemiology diagnosis and management of HAI in children. Many infectious diseases
texts are organized based on the microbiology of infection and from this starting point then
discussing the clinical syndromes associated with the organism of interest. For instance a
chapter on Staphylococcus aureus may contain a brief discussion of the role of S. aureus in
surgical site infections in the wider context of all staphylococcal disease. For clinicians
caring for children at the bedside however the clinical syndrome is typically appreciated and
intervention necessary prior to organism identification. We propose a text that details both
the general principles involved in HAIs and infection prevention but also provides a problem
oriented approach. Such a text would be of interest to intensivists neonatologists
hospitalists oncologists infection preventionists and infectious diseases specialists. The
proposed text will be divided into three principle sections: 1) Basic Principles of Infection
Control and Prevention 2) Major Infectious Syndromes and 3) Infections in Vulnerable Hosts.
Chapters in the Major Infectious Syndromes section will include discussion of the epidemiology
microbiology clinical features diagnosis medical management (or surgical management as
appropriate) and prevention of the disease entity of interest. Chapters will seek to be
evidenced based as much as possible drawing from the published medical literature as well as
from clinical practice guidelines (such as those from the Infectious Diseases Society of
America) when applicable. We intend to include tables figures and algorithms as appropriate to
assist clinicians in the evaluation and management of these often complex patients. Finally we
intend to invite authors to participate in this project from across a number of medical
specialties including infectious diseases infection control critical care oncology and
surgery to provide a multidisciplinary understanding of disease. It is our intent to have many
chapters be co-written by individuals in different subspecialties for instance a
