HOSPITAL ACQUIRED INFECTIONS.

Prepared By Dr. Anees A. AlSaadi

Medical Resident R1.

20.1.2011

INTRODUCTION :

Definition :

Are Group of infections.

No evidence of incubation on admission.

Caused by Variety of organisms.

Could be acute OR chronic.

BURDEN :

Nosocomial infections are widespread.

They are important contributors to morbidity and mortality.

Cost either directly or indirectly.

BURDEN CDC :

1.7 million infections.

99,000 associated

deaths each year.3

5% of all hospitalizations in the US.

WHO: 8.7% of hospitalized

patients had (HAI).

WHAT ARE THE MOST

COMMON INFECTIOUSE

AGENTS ….. ?

INFECTIOUS AGENT:

 ( MRSA).

Tuberculosis.

Invasive group A streptococcal infections .

Influenza.

Clostridium difficile diarrhea .

Scabies .

RESERVOIR:

Humans either the staff or the

patients and medical associated

procedures and environment are

the usual reservoirs in this case.

PORTAL OF EXIST: PORTAL OF ENTRY :

It is variable . It could be through:

Respiratory discharges e.g. influenza viruses.

Stool e.g. Rota virus and adenoviruses.

Skin e.g. Scabies .

Genito urinary

MOOD OF TRANSMISSION :

All means of transmission being involved

Except : Soil contact Vertical.

Host susceptibility

HOST SUSCEPTIBILITY :

Age.

• Neonates.• elderly

patients

Gender.

• No predominance.

Occupation.

• Intensive care units.

• Emergency department.

• Laboratory medicine..

HOST SUSCEPTIBILITY :General medical

condition:• Chronic ill patients.

• Immunocompromised.

• Long term medical devices .

• Long term antibiotics

• Bedridden state.

• Low activities .

Environmental factors:

• Variety of medical procedures.

• Invasive techniques creating potential routes of infection.

• Drug-resistant bacteria.

• Crowded hospital populations.

• Poor infection control practices .

CLINICAL FEATURES :

Pneumonia.

Infectious diarrhea and foodborne illness.

Septicemia.

UTI .

Decubitus ulcers .

Conjunctivitis. 

DIAGNOSIS AND TREATMENT :

Diagnosis is clinical scenario oriented .

Cultures for blood, urine, stool and even sputum samples.

Viral serology should always be considered.

Treatment is case oriented . But the initial must be empirical and wide spectrum coverage.

PREVENTION :

General Measures:

Health education: Not only to the patient or visitors but

medical staff also.

Educate the medical staff about (HAI) mood of transmission . ect.

Hand washing is very important issue .

PREVENTION Health promotion:

Provide the facilities for hand washing and personal hygiene.

Ideal settings to prevent blood diseases transmission.

Facilitate no crowding .

PREVENTION ENVIRONMENTAL Safe water supply .

Prober disinfection.

Sanitary disposal of waste .

Food sanitation and food handlers control..

PREVENTION ENVIRONMENTAL

Dust control .

Control of respiratory droplets .

Regular instrumental sterilization.

Usage of disposal instruments.

Blood and its products screening.

PREVENTION

Administrative measures:Control infection committee :

To formulate the policies for infectious cases admission.

Coordinate all infection control facilities.

Formulates a medical staff rule when being ill.

Formulate rules for the visitors to the hospitals.

PREVENTION : SPECIFIC MEASURES: Vaccination : 

All staff should be vaccinated for the most common organisms .

Chemoprophylaxis :This is applicable in some situations like

in case of T.B contacts like nurses where INH must be given .

CONTROL :

Cases : Early case finding .

Notification :

Isolation : Many infections must be isolated like (active open T.B, MRSA ….ect. )

Disinfection : all patients secretions, fluids ect. Must be ideally disinfected.

Treatment.

Release .

 

( HIV, Hepatitis, Meningitis, T.B ) are of A level .

CONTROL : CASES :

Rehabilitation : so important for both the inpatient and even the medical staff whom become infected by what ever organisms as

(HAI) psychological rehabilitation and reassuring is essential as the medical

rehabilitation.

CONTROL :CONTACTS :

The general rule is applied depending on the case.

Enlistment.

Surveillance for early case finding and testing it by prober laboratory investigation.

Immunization or chemoprophylaxis if applicable.

Treatment is applicable.

ENVIRONMENTAL HAZARDS CONTROL:

Safe water supply .

Prober disinfection.

Sanitary disposal of waste .

Food sanitation and food handlers control.

ENVIRONMENTAL HAZARDS CONTROL:

Dust control .

Control of respiratory droplets .

Regular instrumental sterilization.

Usage of disposal instruments.

Blood and its products screening.

Collaborating .

THANK YOU !