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Hospital infection control
 

Hospital infection control

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    Hospital infection control Hospital infection control Presentation Transcript

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    • Nosocomial infections/ HAI
      • Nosocomial infections are infections which are a result of treatment in a hospital or a healthcare service unit, but secondary to the patient's original condition.
      • Infections are considered nosocomial if they first appear 48 hours or more after hospital admission or within 30 days after discharge.
    • Pathophysiology
      • Within hours of admission, colonies of hospital strains of bacteria develop in the patient's skin, respiratory tract, and genitourinary tract.
      • Interaction between the contaminating organism and the host.
      • Not all colonized individuals develop infection .
      • Persons who have progressed from colonization to infection may represent only the “tip of iceberg” of persons carrying a particular pathogen.
    • Pathophysiology
      • Within hours of admission, colonies of hospital strains of bacteria develop in the patient's skin, respiratory tract, and genitourinary tract.
      • Interaction between the contaminating organism and the host.
      • Not all colonized individuals develop infection .
      • Persons who have progressed from colonization to infection may represent only the “tip of iceberg” of persons carrying a particular pathogen.
    • Classification of Nosocomial Infections (based on)
      • Source of micro-organisms
      • Type of infections
    • Source of micro-organisms
      • Endogenous infections
      • eg: Klebsiella, E.coli
      • Exogenous infections
      • eg: Pseudomonas
    • Type of infections
      • Catheter related blood stream infections (CR-BSI)
      • Urinary tract infections (UTI)
      • Ventilator related pneumonia (VAP)
      • Surgical site infections (SSI)
      • Burns infections
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    • Agent related factors
      • Virulence of the organism (S.aureus, Pseudomonas).
      • Antimicrobial resistance: highly influenced by usage patterns.
      • Resiliency: Ability to survive in the environment.
      • Resistance to disinfectants.
    • Microbal Microbal agents: agents:  Bacteria  Viruses  Parasites  Fungus  MRSA/VRSA  VRE  MDR Acinetobacter  MDR Pseudomonas  ESBL K. pneumo
    • Common bacterial nosocomial infections causing bloodstream infections
    • Nosocomial UTI
      • E. coli
      • Klebsiella
      • Pseudomonas
      • Entero cocci
      • Candida albicans
    • Nosocomial Pneumonia
      • Pseudomonas aeruginosa
      • Klebsiella spp
      • Staph aureus
      • Acinetobacter
      • Legionella
      • Aspergillus
      • Candida
      • Mycoplasma pneumoniae
      • Chlamydia pneumoniae
    • Nosocomial SSI
      • Staph aureus
      • Pseudomonads
      • CoNS
      • Gram negative rods
      • Enterococci
    • Nosocomial Viruses
      • Hepatitis B & C
      • RSV
      • Rotavirus
      • Enterovirus
      • CMV
      • HIV
      • Ebola
      • Influenza virus
      • HSV
      • VZV
    • Nosocomial Parasite & Fungi
      • Giardia lamblia
      • Cryptosporidium
      • Sarcopties scabeii
      • Candida albicans
      • Aspergillus spp.
      • Cryptococcus neoformans
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    • Transmission of Nosocomial Infections Patient to patient Patient to healthcare worker Healthcare worker to patient
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    • Commonly used disinfectants
      • Skin Disinfection (Antiseptic):
      • Isopropyl alcohol (70-80%)
      • Halogens (iodine, iodophores)
      • Quarternary ammonium compounds (cetrimide)
      • Biguanides (chlorhexidine)
      • Phenolics (hexachlorophene, choroxylenols like dettol)
      • Savlon (cetrimide + chlorhexidine)
      •   Heat sensitive instruments:
      •   Glutaraldehyde 2%, hydrogen peroxide 6%
    • Environmental Disinfection
      • Clean surfaces
      • Ethyl alcohol (70%) is good for trolley top and thermometers.
      • Hypochlorite for surfaces with blood spills, viruses, food preparation surfaces.
      • Dirty surfaces
      • Phenolics (Lysol)
      • Sodium hypochlorite
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    • Isolation and containment (in addition to Standard Universal Precautions)  Airborne precautions: droplet nuclei <5 µ m e.g.tuberculosis, chickenpox, measles requires negative air pressure room  Droplet precautions: droplet nuclei >5 µ m e.g. bacterial meningitis, diphtheria, respiratory syncytial virus  Contact precautions: enteric infections diarrhoea , skin lesions  Strict isolation: haemorrhagic fever, SARS
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    • Training and capacity building Training Methodology
      • Combination of:
        • Lectures
        • Practical exercises
        • 5 month course
        • Series of five 1-week courses
        • Practical application
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