What is Nosocomial Infection??•Any infection causing illness that was not present or inits incubation period when the subject entered hospitalor received treatment in outpatient clinic.•Infections are considered Nosocomial if they firstappear 48 hours or more after hospital admission orwithin 30 days after discharge.•“Nosocomial” comes from two Greek words- “nosus”meaning “disease”+”komeion” meaning “to take careof”----disease contracted by a patient while undermedical care.
WHO notes that the rate of nosocomial infection will continue to rise as a result of four factors• Crowded hospital conditions• Increasing number of people with compromised immune systems• New micro-organisms• Increasing bacterial resistance
Routes of Transmission1. Contact2. Airborne3. Commom vehicle4. Vector borneNOTE:The same micro-organism may be transmitted by more than one route
1.Contact route of transmission• May occur through 3 routesDirect contactIndirect contactDroplet contact
Direct Contact Physical transfer Between hospital personnel and patient or Between patients
Indirect contact• Personal contact of hospital personnel with infected instruments, dressings,materials etc.• Due to improper handling of used intruments and equipments
Droplet contact• Droplets generated by coughing,sneezing, or respiratory tract procedures such as bronchoscopy and suction.• Considered as contact transmission as droplets do not travel more than 3ft.
2.Airborne route of transmission• Tiny droplet nuclei that remain suspended in air(<5 microns)• Dust particles inhaled by susceptible host
3.Common Vehicle route• Transmitted indirectly by material contaminated with the infectious agents.(e.g contaminated food, water, blood products, instruments and other items)
4.Vector borne route of transmission• Transmission through disease carrying organisms such as insects , mosquitoes ,fleas etc.
Implications of NCI• Serious disabling conditions-detrimental effect on quality of life• Delayed wound healing• Increased cost due to prolonged hospitalization• Morbidity and mortality• Community risk
MRSA Superbug???• According to the Centres for Disease Control and Prevention: MRSA, which stands for methicillin-resistant Staphylococcus aureus, is a type of staph bacteria that is resistant to several different types of antibiotics.• “SUPERBUG”-called so because it readily spreads especially in crowded living conditions.
How you catch it?• MRSA is spread through contact with someone who already has the infection, using a personal item that has come in contact with someone with an infection or by touching a contaminated surface.
Symptoms of MRSA• MRSA infections are mainly characterized by painful, irritating red bumps and rashes. However, if the bacteria enter the bloodstream, the infection can spread to and damage vital organs. In extreme cases, MRSA infections can be fatal.
Prevention of MSRA Superbug• The best way to keep from getting an infection is maintaining good hygiene• Proper hand washing.• The community as a whole can slow the progression of MRSA by using antibiotics responsibly and sparingly.
NDM-1 Superbug• New Delhi metallo-beta-lactamase-1• Widespread in India,Pakistan and has reached Europe,Australia and Canada.• A highly rare genetic mutation• Highly impermeable to powerful antibiotics.
NCI prevention and control1. Isolation precautions• Airborne precautions(requires negative air pressure room)• Droplet precautions• Contact isolation2. Hand hygiene3. General ward hygiene measures4. Environmental or surface sanitation5. Wearing gloves6. Appropriate handling of soiled linen
2. Hand hygiene• Hand hygiene is the simplest and most effective measure for preventing hospital acquired infections.
Hand hygiene measures1. Alcohol hand rub2. Routine hand wash 10-15 seconds3. Aseptic procedures 1 minute4. Surgical wash 3-5 minutes
Alcohol hand rubs• Requires less time• Readily accessible• All patient care areas• Acts faster• Less irritating• Excellent bactericidal activity• Sustained action