Infection control is the responsibility of all healthcare workers. It aims to protect both patients and HCWs from infections by reducing pathogenic microorganisms through proper sterilization, disinfection, hand hygiene, and use of personal protective equipment. An infection control committee oversees the development and implementation of infection control policies and identifies areas for improvement through epidemiological surveillance.

1. Concept of Infection Control
Dr Kamran Afzal
FCPS, PhD

2. DEFINITIONS
• INFECTION:
An invasion of pathogens or microorganisms into the body that are capable of
producing disease
This invasion and reproduction of microorganisms in a body tissue can result in
a local or systemic clinical response such as cellulitis or fever
• COMMUNITY ACQUIRED INFECTION (CAI)
An infection present or incubating at the time of admission to a hospital
without any association to previous hospitalization at the same facility
• HOSPITAL ACQUIRED INFECTION (HAI/NI)
An infection in a patient which was not present at the time of admission

3. • COLONIZATION
The presence of microorganism in or on a host, with growth and multiplication
but without tissue invasion or damage
• CONTAMINATION
The presence of microorganism on inanimate objects (clothing, surgical
instruments, water, food, milk) or in substances
• EXPOSURE: Contact of specific eye, mouth, other mucous membrane, non
intact skin, or parenteral with blood or other potentially infectious materials

4. • INFECTION CONTROL
It is a program that is designed to protect personnel against risks of infection exposure
• UNIVERAL PRECAUTIONS: All the patients and blood contaminated body fluids are
treated as infectious
• PERSONAL PROTECTIVE EQUIPMENT (PPE): A term used for barriers, such as gloves,
gown, or mask
• HOUSEKEEPING: A term that relates to cleanup of treatment-soiled operatory
equipment, instruments, counters, and floors, as well as to management of used
gowns and waste

5. • STERILIZATION: Use of a physical or chemical procedure to destroy all
microorganisms including resistant bacterial spores
Sterilization means the destruction of all life forms
• STERILE: An article free from all living microorganisms; usually described as a
probability (e.g., the probability of a surviving microorganism being 1 in 1 million)

6. • DISINFECTION: Disinfection is a process of removing or killing most, but not all,
viable organisms
Disinfection refers to the destruction of pathogenic organisms
• DISINFECTANT: A chemical agent used on inanimate objects to destroy virtually
all recognized pathogenic microorganisms, but not necessarily all microbial forms
(e.g., bacterial endospores)

7. Leading Causes of Death

8. Chain of Infection

9. INFECTION CONTROL PRECAUTIONS
• Standard Precautions
• Airborne Precautions
• Universal Precautions
• Barrier Nursing

10. MODES OF TRANSMISSION
• Direct contact with blood or body fluids
• Indirect contact with a contaminated instrument or surface
• Contact of mucosa of the eyes, nose or mouth with droplets
• Inhalation of airborne microorganisms

11. MAIN SOURCES OF INFECTION
• Person to person via hands of HCWs, patients, and visitors
• Hospital staff who are carriers
• Personal clothing and equipment (stethoscopes, flashlights etc)
• Environmental contamination
• Airborne transmission

12. TRANSMISSION OF INFECTION
1. Source of infection – may be a patient or a member of the HCWs who is
suffering from, or is a carrier of, an infectious disease
2. Means of transmission – Microorganisms capable of causing disease are
present in human blood and saliva, contact with blood or saliva may transmit
such pathogenic organisms causing infection
3. Route of transmission – Transmission may occur due to inhalation or
inoculation
4. Susceptible host – Is a person who lacks effective resistance to a particular
microorganism. e.g immune-compromised patients, pregnant women and
children

13. ROUTES OF TRANSMISSION
• Contact Transmission
• Direct
• Indirect
• Droplet Transmission
• Airborne Transmission
• Vector-borne Transmission

14. PORTALS OF ENTRY

15. 1. PATIENTS:
• Lower resistance to infectious microorganisms (due to illness or disease)
• Exposure to an increased number of and more types of disease-causing
organisms
(Hospital harbors a high population of virulent strains of microorganisms
that are resistant to antibiotics)
MRSA, VRE – super bugs
• The performance of invasive procedures
(IV catheters etc.. Anything that crosses protective barriers)

16. 2. Attendants
• The relationship of hospital infections with an increased number of
attendants/visitors is beyond doubt
• They become the carriers of infection putting both at risk of developing infections
i.e. patients and HCWs

17. 3. Healthcare Workers
• Being consistently with the patients while delivering treatment and care, the
healthcare team including doctors, nurses and other paramedical staff are at a
larger risk to develop infections in the healthcare settings

18. MAIN NOSOCOMIAL INFECTIONS

19. SOURCES OF HAI
• Endogenous: Normal flora of the patient- About 50% of NI
• Exogenous:
• HCWs
• Other patients and environment
• Inanimate objects- tools, instruments, and materials used
• Seeding from distant focus of infection (prosthetic device, implants)
• Good infrastructures does not mean a safe environment

20. OBJECTIVES OF INFECTION CONTROL
 To protect the patient and HCWs from contracting infections during procedures
 To reduce the numbers of pathogenic micro-organisms in the potential areas to
the lowest possible level
 To implement a high standard of infection control when treating every patient
(universal precautions)
 To simplify infection control, thus allowing the HCWs to complete treatment
protocols with minimal inconvenience

21. EFFICACY OF INFECTION CONTROL
Following measures will certainly control the infections:
• Hand washing
• Work culture and attitude of HCWs
• Care of inserted devices
• Care of equipment used on body, like in respiratory therapy
• Effective sterilization and disinfection
• Peri-operative antibiotic prophylaxis for contaminated wounds
• Proper disposal of hospital waste
• Laboratory asepsis

22. Infection Control Committee
• It is a multidisciplinary committee responsible for monitoring and
implementation of IC policies and recommend corrective actions
• It establishes standards for patient care, it reviews and assesses IC reports and
identifies areas of intervention
• It includes representatives from different concerned hospital departments and
management
• The ICC reports directly to the top management to promote visibility and
effectiveness of policies

23. Infection Control Committee
Objectives:
• To develop and review its own IC SOPs
• To review and approve surveillance and prevention program
• To review epidemiological surveillance data and identify areas for intervention
• To ensure appropriate staff training
• To ensure availability of appropriate supplies
• To ensure safety management

24. Infection Control is responsibility of ???