Primary prevention
The principal method of primary prevention is immunisation. Advances in biotechnology have led to new and improved vaccines, including vaccines for Haemophilus influenzae type b, Neisseria meningitides (type C), and Streptococcus pneumoniae.[51]
In 2015, the meningococcal B vaccine was introduced into the routine childhood vaccination programme in the UK.[52] In the US, vaccination against meningococcus serogroup B is recommended by the Centers for Disease Control and Prevention (CDC) for children aged 10 years and older who are identified as at increased risk of disease from this bacteria.[53] CDC: Child and adolescent immunization schedule: recommendations for ages 18 years or younger, United States, 2024. Opens in new window Adolescents aged 16-18 years old who are not at increased risk may also be vaccinated. CDC: Child and adolescent immunization schedule: recommendations for ages 18 years or younger, United States, 2024. Opens in new window For meningococcus serogroups A, C, W and Y, the CDC recommends that all children aged 11-12 years old should receive one dose of meningococcal conjugate vaccine (MenACWY) with a booster at age 16 years. CDC: Child and adolescent immunization schedule: recommendations for ages 18 years or younger, United States, 2024. Opens in new window
In 2022, the CDC added a dengue vaccine to its schedule for children aged 9-16 years old with a previous laboratory-confirmed dengue virus infection who live in an area where dengue is endemic. CDC: Child and adolescent immunization schedule: recommendations for ages 18 years or younger, United States, 2024. Opens in new window
Global inequality exists in terms of access to existing vaccine products. The World Health Organization's Global Vaccine Action Plan is a framework to reduce deaths from infection through improving access to vaccines across the world.[54]
Reducing healthcare-associated infections is an important aspect of primary prevention. Because these infections are related to specific interventions (e.g., insertion of vascular catheter), there are opportunities to reduce the risk of infection through improvements in clinical practice (e.g., improved handwashing practices, protective isolation, and universal precautions). An example of a successful initiative in this area is the reduction of venous catheter bloodstream infections in adult and paediatric intensive care units through bundled clinical and non-clinical interventions.[55]
The CDC make recommendations for the prevention of infections in neonatal patients. They recommend that central line type (e.g., umbilical venous catheter, peripherally inserted central catheter, tunnelled catheter, etc.) should be chosen based on the clinical needs of the patient and not solely on central line-associated blood stream infection prevention. In addition, the number of times a central line hub is accessed should be limited to decrease the risk of central line-associated blood stream infection in these patients.[56] The CDC recommend removing umbilical venous and umbilical arterial catheters in neonatal intensive care unit patients as soon as possible and when no longer needed as there is an associated increased risk of central line-associated blood stream infection with each day of increasing dwell time.[56]
Secondary prevention
In adult patients undergoing anti-cancer treatment, the National Institute for Health and Care Excellence in the UK recommends fluoroquinolones during expected episodes of neutropenia for prophylaxis against sepsis complications.[128] This is also common practice in children. Oseltamivir/zanamivir prophylaxis following exposure to influenza virus is also recommended.
Children with cystic fibrosis and other respiratory diseases may be given antimicrobial prophylaxis (e.g., trimethoprim/sulfamethoxazole).
There is currently insufficient evidence to support the use of prophylactic antibiotics for the prevention of infections in children with indwelling central venous catheters.[170]
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