Nosocomial (hospital-acquired) bloodstream infections continue to complicate the clinical course of critically ill patients and, consequently, to create substantial economic and human costs. These infections may lead to complications in approximately 30% of those patients admitted to an intensive care unit (ICU) and cost an estimated $25,000 per infection. Previous studies have shown that the administration of inadequate antimicrobial treatment of bloodstream infections is associated with a significantly higher mortality rate; therefore, strategies to limit bloodstream infections in the ICU have been developed to improve patient outcomes. Although healthcare providers are cognizant of measures to control infection, inconsistent application of these measures remains a concern in the ICU.

In this regional dinner meeting series, we will present up-to-date information on the risk of acquiring nosocomial fungal infections, highlight the most common sites of these infections, and discuss strategies for preventing and controlling bloodstream infections. The goals are to enhance the awareness and understanding of the risks for bloodstream infections and encourage consistent application of infection control measures to promote more favorable outcomes for patients.

• Identify patients at risk for bloodstream infections and multiple drug-resistant pathogens.
• Discuss the cost-effectiveness of antifungal strategies for high-risk patients in the intensive care unit.
• Outline an approach to the prevention and treatment of fungal infections.
• Explain issues with adequate empiric therapy and the morbidity/mortality associated with inadequate treatment.
• Describe de-escalation therapy and its implementation into clinical practice.

Intended Audience
Infectious disease physicians, hospitalists, internal medicine physicians, critical care and intensive care physicians, infectious disease, critical care and ICU nurses, and fellows (surgical and medical); hospital pharmacists, ICU Pharmacists, and hospital formulary committee directors.

Physician Continuing Medical Education
Accreditation Statement
This activity has been planned and implemented in accordance with the Essential Areas and Policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of Postgraduate Institute for Medicine (PIM) and Advanced Studies in Medicine (ASiM). PIM is accredited by the ACCME to provide continuing medical education for physicians.

Credit Designation
Postgraduate Institute for Medicine designates this educational activity for a maximum of 1.5 AMA PRA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

Credit Designation
Postgraduate Institute for Medicine (PIM) designates this continuing education activity for 1.5 contact hour(s) (0.15 CEUs) of the Accreditation Council for Pharmacy Education.
(Universal Program Number – 809-999-08-016-H01-P.)

Disclosure of Conflicts of Interest
Postgraduate Institute for Medicine (PIM) assesses conflict of interest with its instructors, planners, managers and other individuals who are in a position to control the content of CME activities. All relevant conflicts of interest that are identified are thoroughly vetted by PIM for fair balance, scientific objectivity of studies utilized in this activity, and patient care recommendations. PIM is committed to providing its learners with high quality CME activities and related materials that promote improvements or quality in healthcare and not a specific proprietary business interest of a commercial interest.

The faculty reported the following financial relationships or relationships to products or devices they or their spouse/life partner have with commercial interests related to the content of this CME activity:

Dr Karam reports serving as a consultant for Merck & Co, Inc.

Dr Goff reports serving as a consultant for Merck & Co, Inc. and Pfizer Inc.

The planners and managers reported the following financial relationships or relationships to products or devices they or their spouse/life partner have with commercial interests related to the content of this CME/CE activity:

The PIM Clinical Reviewers, including Jan Hixon, RN, BSN, MSN, Trace Hutchison, PharmD, and Linda Graham, RN, BSN, MSN, report having no real or apparent conflicts of interest related to this activity.

ASiM Managers, Chris Washburn, PhD, and Melinda Castro, report having no real or apparent conflicts of interest related to this activity.

Method of Participation
There are no fees for participating and receiving CME credit for this activity. During the period July 2008 through July 2009, participants must 1) read the learning objectives and faculty disclosures; 2) study the educational activity; 3) complete the posttest by recording the best answer to each question in the answer key on the evaluation form; 4) complete the evaluation form; and 5) mail or fax the evaluation form with answer key to Postgraduate Institute for Medicine.

A statement of credit will be issued only upon receipt of a completed activity evaluation form and a completed posttest with a score of 70% or better. Your statement of credit will be mailed to you within 3 weeks.

Media
Webcast.

Disclosure of Unlabeled Use
This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. Postgraduate Institute for Medicine (PIM) and ASiM do not recommend the use of any agent outside of the labeled indications.

The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of PIM and ASiM. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.

Disclaimer
Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patient’s conditions and possible contraindications on dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities.

System Requirements

• DSL, Cable, or faster Internet connection
• At least 256Kbps of dedicated bandwidth per connection on program day
• Internet Explorer 5.0 or newer Web Browser
• Adobe Flash Player
• 16-bit sound card
• 24-bit true color video card
• Windows 98 or newer
  Pentium or AMD Athlon K6 266 MHz processor or faster
• Mac OS 9 or later
  PowerPC G3 233MHz processor or faster
• 128 MB RAM

Post-test and Evaluation Form

Click here for the Post-test and Evaluation Form