For Pharmacy, Medicine and Nursery staff

1. INFECTION PREVENTION
AND CONTROL (IPC)
By:
Dr. Mohammed Salah, Ph.D.
Lecturer of Microbiology and Immunology
E-mail: Mohammed_salah@Azhar.edu.eg 1
Dr. Mohammed Salah

2.  Outlines
1. Introduction
2. Definition of infection control
3. Infection Spread in Healthcare settings
4. Chain of infection
5. Breaking the chain of infection
6. Standard infection control precautions (SICPs)
Dr. Mohammed Salah 2

3.  Introduction
 There are many diseases that can spread easily in our community if controls
are not in place.
 To protect your own health as well as the health of those around you, an
understanding of infectious diseases, how they are spread and how to control
them is fundamental.
Dr. Mohammed Salah 3

4.  Infectious diseases
 Infectious diseases are disorders that are caused by organisms, usually
microscopic in size, such as bacteria, viruses, fungi, or parasites that are
passed, directly or indirectly, from one person to another
Bacteria T.B
Virus Influenza
Fungi Oral thrush
Parasite Bilharzia
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5.  Definition of infection
• The invasion and growth of pathogen in the body, followed by
multiplication and producing its metabolites, leading to harmful effects
• Infections can begin anywhere in the body and may spread all through it.
So, what is the pathogen?
• A pathogen is defined as an organism causing
disease to its host, with the severity of the disease
symptoms referred to as virulence.
• Pathogens are taxonomically widely diverse
and comprise viruses and bacteria as well as
unicellular and multicellular eukaryotes
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6. Host cell
MO
1. Adhesion
Target receptor
Ligand
2. Invasion
 General mechanism of infection
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7. 3. Multiplication
Host cell
MO MO
MO
MO
MO MO
4. Colonization
…………..
…………..
……
……..
……
……
..
Release of toxins & Virulance factors
Cell rupture & Disease occur
 General mechanism of infection
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8.  Infection and colonization
Infection:
Means that germs are in or on the body
and make you sick, which results in
signs and symptoms such as fever, pus
from a wound, a high white blood cell
count, diarrhea, or pneumonia.
• Colonization:
Means germs are on the body but
do not make you sick.
People who are colonized will
have no signs or symptoms
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9.  Occurrence of infection
 Three things are necessary for an infection to occur:
1) Source:
Places where infectious agents (germs) live (e.g., surfaces, human skin)
2) Susceptible Person
with a way for germs to enter the body
3) Transmission:
a way germs are moved to the susceptible person
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10.  Nosocomial infection (HAI)
 Nosocomial infections also referred to as healthcare-associated infections
(HAI), are infection(s) acquired during the process of receiving health care
that was not present during the time of admission.
 Some of the common nosocomial infections are:
1. Urinary tract infections
2. Respiratory pneumonia
3. Surgical site wound infections
4. Bacteremia
5. Gastrointestinal infections
6. Skin infections
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11.  Asepsis
Definition:
Asepsis is a condition in which no living disease-causing microorganisms are
present including procedures designed to reduce the risk of bacterial, fungal or viral
contamination, using:
1. sterile instruments,
2. sterile draping
3. the gloved 'no touch' technique.
a. Medical asepsis
is the state of being free from disease causing microorganisms.
Medical asepsis is concerned with prevention of the spread of microorganisms
through facility practices
b. Surgical asepsis
is practices that completely kill and eliminate microorganisms.
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12.  Epidemiological Triad
1. The Agent - The microorganism that
causes the infection
2. The Host - The target of the disease
3. The Environment - The surroundings
and conditions (these are external to the
host)
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The spread of infectious disease requires three variables,
known as the epidemiological triad:

13.  Infection Spread in Healthcare settings
• In a healthcare setting, the three components required for infection spread
are the following:
1. Source:
places where infectious agents survive.
a) Environment: patient care areas, sinks, hospital equipment,
countertops, medical devices.
b) People: patients, healthcare workers, or visitors.
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14.  Infection Spread in Healthcare settings
2. Susceptible Person:
Someone (Patient, Healthcare Worker, or Visitor) who is not vaccinated or
immune to a, or an individual with a compromised immune system for
particular infectious disease
In addition, susceptibility can be heightened in individuals due to underlying
medical conditions, medications, and necessary treatments and procedures
that increase the risk of infection (for example, surgery).
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15.  Infection Spread in Healthcare settings
3. Transmission:
The way that germs are moved from source to the susceptible person
• Touch, including via medical equipment or a susceptible person (for
example, MRSA or VRE)
• Sprays or splashes (for example, Pertussis)
• Inhalation of aerosolized particles (for example, TB or Measles)
• Sharps injuries introducing blood-borne pathogens (for example, HIV, HBV, HCV)
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16. Infection prevention and control
(IPC)
• Infection control refers to the policy and procedures implemented to control and
minimize the spread of infections in hospitals and other healthcare settings to
reduce the infection rates.
• In other words, infection control is a
set of methods used to control
and prevent the spread of infection among
patients and health workers
• The main purposes of infection control:
1. Reduce occurrence of infectious diseases
2. Prevent transmission of communicable
diseases
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17.  Successful infection control
A. Maintaining a safe environment for
people, patients and Health Care
Workers (HCWs) in a healthcare
setting.
B. Identifying hazards and classifying
the associated risks.
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This task requires cooperation between management, HCWs
and support staff.

18.  Infection cycle
To prevent the spread of
infection, break any one of
the links in the chain.
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19.  Infection cycle
1. Infectious agent:
For example, bacteria, virus and fungi, are disease causing agents
factors affect the potential of microorganism to causes a disease are:
a. number of organism
b. host immune response
c. length of contact between host and causative M.O
2. Reservoir:
The reservoir is where the infectious agent lives and multiplies.
A reservoir could be a body of water, food, human, or animal.
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20.  Infection cycle
3. Portal of exit:
The portal of exit is the way that the infectious agent leaves its reservoir.
Common routes:
a. respiratory: coughing, sneezing
b. genitourinary tract: folly catheter, sexually transmitted diseases
c. GIT: feces and vomiting
d. Skin and mucous membranes: skin breaks and wounds
e. blood and tissue: needle stick and blood transfusion
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21.  Infection cycle (cont.)
4. Mode of transmission:
Microoraganisms can not travel on their ownthey require avehicle to carry them to other people and
places
The mode of transmission explains how the infectious agent gets from the reservoir to the new host.
Common ways:
a. Direct
Direct contact
Droplet spread
b. Indirect
Airborne
Vehicle borne (oral feacal)
Vectorborne (mechanical or biologic)
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22.  Infection cycle (cont.)
5. Portal of entry:
The portal of entry is how the
infectious agent enters into the new
host
6. Susceptible host:
A susceptible host is the recipient of
the infection
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23.  People at high risk of infection?
1. Staff:
because they are exposed to blood and other body fluids
2. Clients:
they are at high risk of post procedural infections
e.g. service provider don not wash hands between client and procedure
e.g. not cleaned instruments
3. Community:
inappropriate disposal of medical waste
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24.  Breaking the chain of infection
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25.  Breaking the chain of infection
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Break the chain by:
1. Cleaning your hands frequently,
2. Staying up to date on your vaccines (including the flu shot),
3. Covering coughs and sneezes and staying home when sick,
4. Following the rules for standard and contact isolation,
5. Using personal protective equipment the right way,
6. Cleaning and disinfecting the environment,
6. Sterilizing medical instruments and equipment,
7. Following safe injection practices,
8. Using antibiotics wisely to prevent antibiotic resistance.
Preventing infection means breaking the links in the chain so that an
infection cannot spread

26.  How to Implement Infection Control?
1. Promote infection control as standard practice.
2. Have processes and protocols in place.
3. Have appropriate facilities and consumables
(allocate funds).
4. Signage ‫الفتات‬ e.g. correct hand washing technique.
5. Provide and take part in training sessions.
6. Maintain records of training.
7. Promote vaccination.
8. Adopt a risk management approach to infection control.
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27.  Standard infection control precautions (SICPs)
Standard infection control precautions (SICPs) are to be
used by:
all staff, in all care settings, at all times, for all patients
whether infection is known to be present or not, to ensure
the safety of those being cared for, staff and visitors in the
care environment.
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28.  Standard infection control precautions (SICPs)
SICPs are the basic infection prevention and control measures
necessary to reduce the risk of transmitting infectious agents from
both recognised and unrecognised sources of infection.
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Sources of (potential) infection include blood and other body fluids,
secretions or excretions (excluding sweat), non-intact skin or
mucous membranes and
any equipment or items in the care environment that could have
become contaminated.

29.  There are 10 elements of SICPs:
1. Patient placement/assessment of infection risk
2. Hand hygiene
3. Respiratory and cough hygiene
4. Personal protective equipment (PPE)
5. Safe management of the care environment
6. Safe management of care equipment
7. Safe management of healthcare linen
8. Safe management of blood and body fluids
9. Safe disposal of waste (including sharps)
10. Occupational safety/managing prevention of exposure (including sharps)
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30.  1. Patient placement/assessment for infection risk
 Mean that patients must be assessed for infection risk on arrival at the care
area, e.g. inpatient/outpatient/care home, (if possible, prior to accepting a
patient from another care area) and should be continuously reviewed
throughout their stay.
 This assessment should influence placement decisions in accordance with
clinical/care need(s).
 Patients who may present a cross-infection risk include those:
1. with diarrhea, vomiting, an unexplained rash, fever or respiratory
symptoms
2. known to have been previously positive with a multi-drug resistant
organism (MDR), e.g. MRSA, CPE
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31.  2. Hand hygiene
 Hand hygiene is considered one of the most important ways to
reduce the transmission of infectious agents that cause
healthcare associated infections (HAIs).
 Before performing hand hygiene:
I. expose forearms (bare below the elbow)
II. remove all hand and wrist jewelry.
III. ensure fingernails are clean and short, and do not wear
artificial nails or nail products
IV. cover all cuts or abrasions with a waterproof dressing
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32.  2. Hand hygiene (cont.)
 5 Moments for Hand Hygiene
a) before touching a patient.
b) before clean or aseptic procedures.
c) after body fluid exposure risk
d) after touching a patient; and
e) after touching a patient’s immediate surroundings
Always perform hand hygiene before putting on and
after removing gloves.
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 2. Hand hygiene (cont.)

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35.  QUEZ
A. Define each of the following
A. IPC
B. HAI
C. SICPs
B. Moments for Hand Hygiene
C. Epidemiological Triad
D. Elements of SICPs
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