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INFECTION CONTROL
Presented by: Mrs. Anita.F.Lopes,
BSN, MSN,RN.
Nosocomial infections affects approximately 2 million patients annually in acute care facilities in our country and their annual patient care costs several millions of rupees.
WHAT IS HOSPITAL INFECTION CONTROL PROGRAM?
Hospital infection control program is dedicated to assist the Public Health Services, State and Local Health Departments, Hospitals and other professional organizations in the prevention and control of nosocomial infections.
WHAT DO WE MEAN BY FOLLOWING INFECTION CONTROL……??
AIM OF THE HOSPITAL INFECTION CONTROL PROGRAM
Dissemination of information Surveillance activities Investigation Prevention Control of nosocomial infections
in the hospitals.
Studies shows that nearly one-third of nosocomial infections can be prevented by a well organised infection control programme. But only less than 10% are actually prevented.
WHAT IS INFECTION?
An infection is the colonization of a host organism by parasite species.
Infecting parasites seek to use the host's resources to reproduce, often resulting in disease.
WHAT IS INFECTION CONTROL??
Infection control is the discipline concerned with preventing nosocomial or healthcare-associated infection.
WHICH ARE THE CAUSATIVE ORGANISMS??
Microscopic organisms or micro parasites like viruses, bacteria, though larger organisms like macro parasites and fungi can also infect.
WHAT IS NOSOCOMIAL INFECTION? Nosocomial infections are infections
that are a result of treatment in a hospital or a healthcare service unit.
Infections are considered nosocomial if they first appear 48 hours or more after hospital admission or within 30 days after discharge.
Nosocomial infections are commonly transmitted when hospital personnel do not practice correct hygiene regularly.
Moreover, some medical procedures bypass the body's natural protective barriers.
Since medical staff move from patient to patient, the staff themselves serve as a means for spreading pathogens.
Essentially, the staff act as vectors.
HOW DOES INFECTION SPREAD?
Contact transmission.Direct transmissionIndirect transmission• Droplet transmission• Airborne transmission• Vector borne transmission
FOLLOWING STANDARD PRECAUTIONS…….???
WHO ARE AT RISK?? *New Born & young infants
*Immunocompromised patients *Critically sick, debilitated or unconscious child *Surgical, oncological or burns cases
*Invasive devices *Prolonged antibiotic theraoy
*Prolonged hospitalization.
WHICH PROCEDURES CAN CAUSE INFECTION?
* Urinary catheterization* Respiratory procedures* Surgery and wounds* Intravenous procedures
WHICH NOSOCOMIAL INFECTIONS ARE COMMONLY SEEN IN CHILDREN?
* Surgical wound infection * Respiratory tract infections * Urinary tract infections * Bacteraemia & septicemia
*Gastrointestinal infection *Skin infection
*Transfusion related infection *Immunocompromised children: Candid & anerobic infections
HOW CAN WE PREVENT SPREAD OF INFECTION?
Hand washing Gloving PPE: Gowns, Aprons, Masks Isolation Surface Sanitation Mitigation
WHICH ARE THE COMMON ORGANISMS CAUSING HAVOC IN OUR CLINICAL AREAS?
The organisms are as follows…...
STAHYLOCOCCUS AUREUS METHICILLIN RESISTENT
STAHYLOCOCCUS AUREUS KLEBSEILLA PSEUDOMONAS INFECTIONS CLOSTRIDIUM PERFRINGENS STREPTOCOCCI
STAPHYLOCOCCUS Staphylococcus is a genus of Gram-positive
bacteria Produces toxin production or invasion by
colonization. Can survive on dry surfaces, increasing the
chance of transmission. S. aureus is also implicated in
toxic shock syndrome; during the 1980s some tampons allowed the rapid growth of S. aureus, which released toxins that were absorbed into the bloodstream.
STAPHYLOCOCCUS WOUND…
THE SUPER BUG!!!....MRSA
MRSA- ‘SUPER BUG’
MRSA is, by definition, any strain of Staphylococcus aureus bacteria that has developed resistance to beta lactum antibiotics which include the penicillins (methicillin, dicloxacillin, nafcillin, oxacillin, etc.) and the cephalosporins.
The discovery of MRSA… Was discovered in 1961 in the
United Kingdom. First major appearance in the
United States in 1981 among intravenous drug users.
MRSA is often referred to in the press as a "superbug".
MRSA infected wound
IS THERE A KNOWLEDGE DEFICIT ABOUT MRSA????
MRSA infection spreads…..to all corners of the hospital….unless isolated
WHERE CAN MRSA INFECT?
Respiratory tract, Opened wounds, Intravenous catheters, and Urinary tract
How to identify MRSA infections?
24–48 hours of initial topical symptoms : small red bumps that resemble pimples, spider bites, or boils that may be accompanied by fever and occasionally rashes.
How to identify MRSA infections?...contd
After 72 hours MRSA can take hold in human tissues: Within a few days the bumps become larger, more painful, and eventually open into deep, pus-filled boils.
MRSA BLISTER
BAD NEWS: MRSA
MRSA infections can affect vital organs and lead to widespread infection (sepsis), toxic shock syndrome and necrotizing ("flesh-eating") pneumonia.
GOOD NEWS:
About 75 percent of community-associated (CA-) MRSA infections are localized to skin and soft tissue and usually can be treated effectively.
KLEBSIELLA
KLEBSIELLA
Klebsiella pneumoniae is a Gram negative, non motile, encapsulated, lactose fermenting anaerobic, rod shaped bacteria.
It is found in the normal flora of the mouth, skin, and intestines.
It naturally occurs in the soil, and about 30% of strains can fix nitrogen in anaerobic conditions.
How does Klebsiella effect?
The most common infection caused by Klebsiella bacteria outside the hospital is pneumonia.
Klebsiella: Throat infections
Klebsiella –skin infections
THE STREPTOCOCCI…
KNOWING STREPTOCOCCUS
Streptococcus is a genus of spherical Gram-positive bacteria
Where is it found? Streptococci are also part of the
normal microbe of the mouth, skin, intestine, and upper respiratory tract of humans.
Types of streptococci
Alpha-hemolytic Beta-hemolytic *Group A, B, C, G streptococci• Group D: Non- hemolytic
Which infections are caused by streptococci?
Streptococcal pharyngitis (or strep throat) Meningitis, bacterial pneumonia,
endocarditis. Necrotizing fasciitis (the 'flesh-eating'
bacterial infections).
PHARYNGITIS…BY STREPTOCOCCI
PSEUDOMONAS
ACQUAINTING WITH PSEUDOMONAS
Pseudomonas aeruginosa is a gram-negative, oxidase-positive, motile rod, which frequently grows on agar in yellow-green iridescent colonies.
WHERE IS IT FOUND IN HOSPITAL?
Pseudomonas infections frequently found in moist areas such as sinks, antiseptic solutions, and urine receptacles.
WHERE IS IT FOUND IN HUMANS?
Pseudomonas can be found on hands & occasionally in the axilla and anogenital areas of normal skin
THE PSEUDOMONAS WOUND…..
Which infections are caused by pseudomonas?
Causes infection in tissues that are exposed to the external environment.
Pseudomonas infections can develop in many anatomic locations, including skin, subcutaneous tissue, bone, ears, eyes, urinary tract, and heart valves.
HOW DOES PSEUDOMONAS EFFECT IN BURNS?
In burns, the region below the eschar can become heavily infiltrated with organisms, serving as a focus for subsequent bacteremia (blood stream invasion) - an often lethal complication of burns.
Which is the route of entry for pseudomonas infection?
IV catheter. Endotracheal intubation, Tracheostomy
How to recognize pseudomonas infection? Fever, chills, and the production
of purulent matter in infected wounds.
IS THIS TISSUE NORMAL???
NO….It is Gas gangrene
WHAT IS GAS GANGRENE?
It is a medical emergency. Gas gangrene (also known as "Clostridial
myonecrosis", and "Myonecrosis") is a bacterial infection that produces gas tissues in gangrene.
It is a deadly form of gangrene usually caused by Clostridium perfringens bacteria.
WHERE IS Clostridium perfringens FOUND?
Soil-borne anaerobic bacteria.
HOW DOES IT ENTER THE BODY?
These micro organisms are opportunistic and, in general, enter the body via significant skin breakage.
Is also found as normal gut flora. The bacteria enter the muscle through
a wound
What does it do? Bacteria cause myonecrosis via
specific exotoxins. Myonecrosis is a condition of necrotic
damage, specific to muscle tissue. Proliferate in necrotic tissue and
secrete powerful toxins. These toxins destroy nearby tissue, generating gas at the same time.
What is the composition of this gas? 5.9% hydrogen, 3.4% carbon dioxide, 74.5% nitrogen and 16.1% oxygen.
Treatment Usually debridement and excision with
amputation is necessary in many cases. Antibiotics alone are not effective
because they do not penetrate ischemic muscles enough to be effective.
However, penicillin is given as an adjuvant treatment to surgery.
In addition to surgery and antibiotics, hyperbaric oxygen therapy (HBOT) is used.
ACTIVITY How will a nurse differentiate a staphylococcus
wound from pseudomonas wound? GROUP 1 What precautions should be followed for MRSA
patient? GROUP 2 If a pseudomonas culture is found in the ward,
then what should be done? GROUP 3 What are standard precautions? GROUP 4 Which is the best step to prevent transmission of
infection? GROUP 4
Infection control MUST be religiously practiced by all health care person through out this lifetime…through out all seasons.
THANK YOU
