Successfully reported this slideshow.
We use your LinkedIn profile and activity data to personalize ads and to show you more relevant ads. You can change your ad preferences anytime.

Hospital acquired infection


Published on

Published in: Health & Medicine
  • Be the first to comment

Hospital acquired infection

  1. 1. BY; Kashif Nadeem Khokhar January, 30, 2013
  2. 2. Hospital acquired infection •  are generally Hospital Acquired Infections known as Nosocomial Infections or Health-care Associated Infections (HAI). • HAI do NOT originate from patient’s original diagnosis. • Infections that become clinically evident, 48 Hours after hospitalization are called HAI. • If infections are acquired during hospitalization but become evident after discharge, they are said to have Nosocomial Origin.
  3. 3. PATHOPHYSIOLOGY   Risk Factors for invasion of pathogens are categorized into 3 Areas, Iatrogenic, Organizational, and patient related.  Iatrogenic RF include, Pathogens present on Medical Personnel hands, Invasive Procedures (e.g. intubation, urine catheterization) and Antibiotic use and prophylaxis.  Organizational RF include contaminated air-conditioning and water system, and staffing and physical layout of the facility. (e.g. Nurse-to-patient ratio, open bed distance).  Patient RF include, severity of illness, underlying immuno-compromised state, and Length of the stay.
  4. 4. CLINICAL CAUSES   HAI are caused by Viral, Bacterial and Fungal pathogens.  During Hospital Stay, many patients acquire Rotaviral infections and Viral Respiratory infections in Winter, (e.g. Influenza). And Enteroviral infections in Summer.  Viruses are Responsible for up to 14% of HAI, with Identifiable pathogens in Pediatric Patients.  Bacterial and Fungal infections are less Common.  Bacterial infections are mostly caused while placing Intravascular lines and Urinary Catheters.  Fungal infections mostly arise from Patient’s own Flora.
  5. 5. SIGNS AND SYMPTOMS  Fever, Tachycardia, Skin Rash, General Malaise can be Physical signs and symptoms. Instrumentation is a most common source of HAI, Endotracheal Tube may be Associated with Sinusitis, Tracheitis and Pneumonia. Intravascular Catheter may be source of Phlebitis or line infection.
  6. 6. MOST COMMON HOSPITAL ACQUIRED INFECTIONS   Candidiasis  Colitis  Endocarditis (Bacterial & Fungal)  Enteroviral Infections  Hepatitis C  Influenza  Legionella Infections  Toxic Shock Syndrome  Pseudomonas Infections  Rhinovirus Infections  Urinary Tract Infections ( UTI ).
  7. 7. DIAGNOSIS   A detailed Physical Examination (PE) and Review of the systems, Reveal the involved Organs & Systems.  Study should be centered on Infections of Bloodstream , UTI, and Pneumonia, unless, An Obvious Source (e.g. Surgical-Site infection) is readily Identified.  Blood cultures, Radiography, Sputum Culture, Gram staining, Acid-Fast Staining, Fungal Cultures, and Viral Cultures can be helpful for diagnosing HAI.  Special Imaging Techniques (e.g. Sonography, CT, or MRI) can be helpful in Evaluating Obscure Site Infections.
  8. 8. TREATMENT  Medical Care; Symptomatic Treatment for Shock, Hypoventilation and other Complications is provided, Along with the Administration of Empiric Broad Spectrum Antimicrobials, Antifungals and Antivirals.
  10. 10. BLOOD-STREAM INFECTIONS  Broad-Spectrum Antibiotics should be Selected according to the Microbial Susceptibility. Antifungals (e.g. Fluconazole) can be added to Empiric Antibiotics in Some Cases. Antivirals (e.g. Acyclovir) can be used for Viral Infections.
  11. 11. PNEUMONIA  Broad-Spectrum Antibiotics are used. Macrolide Antibiotics are indicated in Legionellosis. Antivirals (e.g. Amantadine, and Rimantadine) are used for Viral Pneumonia, ( for patients over age 1 year ). The most Cost-Effective Prevention measure is Vaccination against Influenza A and B.
  12. 12. URINARY TRACT INFECTIONS ( UTI )  Indwelling Catheters should be Removed, if Feasible. Empiric Antibiotic and Antifungal Therapy, based on Results of Urinalysis and Urine Gram Staining.
  13. 13. CONSULTATIONS  Many Nosocomial Infected patients require Expert Care from an ICU Team. Infectious Disease Specialists, BurnCare Specialists, And Surgical Teams, Usually are involved in the care of These Complicated Cases.
  15. 15. Bacterial Agents  Multiple-Resistant Organisms, such as  Vancomycin-Resistant S. aureus, and  Inducible or Extended-Spectrum Betalactamase Gram-Negative Organisms Are Constant Threat.
  16. 16. VIRAL AGENTS  The Rapid spread of Respiratory Syncytial Virus ( RSV ) among Pediatric Patients during an RSV Epidemic, poses a Threat to Children, Who Require Hospitalization during Winter Months.
  17. 17. Facts & Figures
  18. 18. FREQUENCY  In United States, Hospital Acquired Infections are Estimated to occur in 5% of all Acute Hospitalizations. The highest Rates of infection occurs in The Burn ICU, Neonatal ICU, and Pediatric ICU. Mortality Rate is about 90,000 deaths per Year in USA due to HAI.
  19. 19. SURVEY REPORT   Among 6,290 Pediatric Patients Surveyed between 1992-1997, The Incidence of HAI were as Follows,  Bloodstream Infections, 28%  Ventilator Associated Pneumonia, 21%  Urinary Tract Infections ( UTI ), 15%  Lower Respiratory Infections, 12%  GI, Skin, Soft Tissue and CV Infections, 10%  Surgical Site Infections, 7%  ENT Infections, 7%
  20. 20. LATEST SURVEY   In Ireland, 3,992 in-patients across 16 acute and local Hospitals were Surveyed in 2012.  Overall only 4.2% Patients had HAI.  Respiratory Infections, 27.9%  Surgical Site Infections, 18.9%  Urinary Tract Infections, 11.8%  Patients taking more than 1 Antibiotic, 10.9%  Overall Use of Antibiotics for HAI, 18.3%
  21. 21. THANK YOU SO MUCH…!!!!!  Kashif Nadeem Khokhar