Intensive care units experience high rates of infection due to patients having more comorbidities and invasive devices, with ventilator-associated pneumonia, central line-associated bloodstream infections, and catheter-associated urinary tract infections being common; infection control strategies like hand hygiene, isolation precautions, environmental cleaning, and surveillance are effective at reducing the transmission of multidrug-resistant pathogens in ICUs and improving patient outcomes. Surveillance of device-associated infection rates and antimicrobial resistance patterns is important for guiding infection control efforts and antimicrobial stewardship in the ICU.
A "bundle" is a
group of evidence-based care components
for a given disease that, when executed together, may result in better outcomes than if implemented individually.
A "bundle" is a
group of evidence-based care components
for a given disease that, when executed together, may result in better outcomes than if implemented individually.
Catheter-associated Urinary Tract Infections (CAUTI)
A urinary tract infection (UTI) is the most common type of healthcare-associated infection reported to the National Healthcare Safety Network (NHSN). Among UTIs acquired in the hospital, approximately 75% are associated with a urinary catheter, which is a tube inserted into the bladder through the urethra to drain urine. Between 15-25% of hospitalized patients receive urinary catheters during their hospital stay. The most important risk factor for developing a catheter-associated UTI (CAUTI) is prolonged use of the urinary catheter. Therefore, catheters should only be used for appropriate indications and should be removed as soon as they are no longer needed.
Infection control protocols in intensive care unitsANILKUMAR BR
Hospital acquired infections (HAIs) are common in intensive care unit (ICU) patient and are associated with increased morbidity and mortality.
The main reason being severity of illness, interruption of normal defense mechanism (e.g. mechanical ventilation), malnutrition & inability to ambulate make it more susceptible to multi drug resistant organism (MDRO).
The most frequent mode of transmission is Contact transmission, this may be direct or indirect other modes include droplet transmission, airborne transmission, common vehicle such as ventilator etc.
Central-Line-Associated Bloodstream Infections (CLABSI) pause a major health problem in hospitalized patients. This disease is associated with people with a central line/tube inserted through the skin into the large vein, which can be used to give medicines, fluids, nutrients, or blood products to patients in critical conditions. The disease occurs when microbes enter through the central line invading the bloodstream.
Prevention of Central Line Associated Blood Stream Infection (CLABSI )[compa...drnahla
Infection Control Guidelines for Prevention of Central Line Associated Blood Stream Infection (CLABSI )
Dr. NAHLA ABDEL KADERوMD, PhD.
INFECTION CONTROL CONSULTANT, MOH
INFECTION CONTROL CBAHI SURVEYOR
Infection Control Director, KKH.
Importance of infection control in ICU
Ventilator-associated Pneumonia definition and bundles, Central line-associated infection and its bundles and foley's catheter-associated infection and its bundles
this presentation in reference to CDC and IMO
Ventilator associated pneumonia (VAP) was defined as per the Center of Disease Control (CDC) as a pneumonia that occurs in a patient who was intubated and ventilated at the time of or within 48 h before the onset of the event. Pneumonia was identified using a combination of radiological, clinical, and laboratory criteria
Catheter-associated Urinary Tract Infections (CAUTI)
A urinary tract infection (UTI) is the most common type of healthcare-associated infection reported to the National Healthcare Safety Network (NHSN). Among UTIs acquired in the hospital, approximately 75% are associated with a urinary catheter, which is a tube inserted into the bladder through the urethra to drain urine. Between 15-25% of hospitalized patients receive urinary catheters during their hospital stay. The most important risk factor for developing a catheter-associated UTI (CAUTI) is prolonged use of the urinary catheter. Therefore, catheters should only be used for appropriate indications and should be removed as soon as they are no longer needed.
Infection control protocols in intensive care unitsANILKUMAR BR
Hospital acquired infections (HAIs) are common in intensive care unit (ICU) patient and are associated with increased morbidity and mortality.
The main reason being severity of illness, interruption of normal defense mechanism (e.g. mechanical ventilation), malnutrition & inability to ambulate make it more susceptible to multi drug resistant organism (MDRO).
The most frequent mode of transmission is Contact transmission, this may be direct or indirect other modes include droplet transmission, airborne transmission, common vehicle such as ventilator etc.
Central-Line-Associated Bloodstream Infections (CLABSI) pause a major health problem in hospitalized patients. This disease is associated with people with a central line/tube inserted through the skin into the large vein, which can be used to give medicines, fluids, nutrients, or blood products to patients in critical conditions. The disease occurs when microbes enter through the central line invading the bloodstream.
Prevention of Central Line Associated Blood Stream Infection (CLABSI )[compa...drnahla
Infection Control Guidelines for Prevention of Central Line Associated Blood Stream Infection (CLABSI )
Dr. NAHLA ABDEL KADERوMD, PhD.
INFECTION CONTROL CONSULTANT, MOH
INFECTION CONTROL CBAHI SURVEYOR
Infection Control Director, KKH.
Importance of infection control in ICU
Ventilator-associated Pneumonia definition and bundles, Central line-associated infection and its bundles and foley's catheter-associated infection and its bundles
this presentation in reference to CDC and IMO
Ventilator associated pneumonia (VAP) was defined as per the Center of Disease Control (CDC) as a pneumonia that occurs in a patient who was intubated and ventilated at the time of or within 48 h before the onset of the event. Pneumonia was identified using a combination of radiological, clinical, and laboratory criteria
Contrary to their reputation as havens of healing, hospitals are home to invisible dangers known as germs that pose harm to patients and healthcare professionals alike. Hospital germ exposure has a wide range of risks, including the potential for infections, worse patient outcomes, and difficulties in preserving a secure medical environment. We examine the many aspects of hospital germ exposure in this thorough analysis, providing insight into the possible outcomes and risk-reduction tactics.
Infection Prevention and Control in Hospitals by Dr DeleKemi Dele-Ijagbulu
Infection prevention and control is everybody's business! It is an essential, though often under-recognised and under supported part of the infrastructure of health care. However it saves lives and prevents avoidable morbidity and mortality. This presentation highlights the importance and the practical components of infection prevention and control in the hospital setting.
this presentation is help to the student for the getting information regarding the sorces, types, & mode of infection spread in the hospital sector, it help firstd year student student gain the information regarding through this ppt
updated guidelines of hospital infection control, as mentioned in the ppt. its not all the guidelines but yes a brief overview and for further details refer to hospital infection control guidelines pdf.which is available in my uploads.
Preventing Hospital-Acquired Infections: Best Practices and StrategiesVamsi kumar
These notes will provide an overview of hospital-acquired infections (HAIs) and the importance of preventing them. We will discuss the common types of HAIs, such as surgical site infections, bloodstream infections, and urinary tract infections, as well as the factors that contribute to their occurrence. Additionally, we will explore various strategies and best practices for preventing HAIs, such as hand hygiene, environmental cleaning, and antibiotic stewardship programs. The notes will also cover the roles of healthcare providers, patients, and hospital administrators in preventing HAIs and the importance of communication and collaboration between all stakeholders. Overall, these notes will be a comprehensive guide to reducing the incidence of HAIs and improving patient safety in healthcare settings.
A brief yet comprehensive coverage of ICU role in ECMO cases. Presentation has been prepared in order to help ICU fellows and registrars to understand the importance of their role and to know necessary actions they have to take in case of need.
A simplified description of basal ganglia stroke to help understand the clinical scenarios where patients present with neurological symptoms not clearly pointing towards possibility of stroke.
Vertebral artery pseudo-aneurysms and dissections are known to occur as a result of mechanical
manipulations of the cervical region, traumatic injury, spontaneously and iatrogenic injury because of central
venous catheterization. Central venous lines have become an integral part of patient care, but they are
not without complications. Vertebral artery injury (leading to pseudo-aneurysm and dissection) is one of
the rarer complications of central venous catheter placement. We report a case of inadvertent vertebral
artery catheterization during a dialysis catheter placement which subsequently demonstrated arterial
blood. Duplex ultrasound and computed tomographic (CT) scan confirmed vertebral artery catheterization.
It was successfully treated with open surgical technique by the vascular surgeon because of the size of
catheter and subsequent requirement of artery repair. There were no neurological sequelae. Open surgical
repair remains the gold standard of treatment. Endovascular repair of vertebral artery pseudo-aneurysms
has been described with promising outcomes, but long-term results are lacking. This case report describes
the rare iatrogenic event of vertebral artery injury and reviews its etiology, diagnosis, complications, and management.
From eye drops to icu, a case report of three side effects of ophthalmic timo...Muhammad Asim Rana
Timolol Maleate (also called Timolol) is a nonselective beta-adrenergic blocker and a class II antiarrhythmic drug, which is used
to treat intraocular hypertension. It has been reported to cause systemic side effects especially in elderly patients with other
comorbidities.These side effects are due to systemic absorption of the drug and it is known that Timolol is measurable in the serum
following ophthalmic use. Chances of life threatening side effects increase if these are coprescribed with other cardiodepressant
drugs like calcium channel or systemic beta blockers. We report a case where an elderly patient was admitted with three side
effects of Timolol and his condition required ICU admission with mechanical ventilation and temporary transvenous pacing.The
case emphasizes the need of raising awareness among physicians of such medications about the potential side effects and drug
interactions. A close liaison among patient’s physicians is suggested.
Congenitally absent Inferior Vena Cava: A rare cause of recurrent DVT and non...Muhammad Asim Rana
In search of a cause for the so-called idiopathic Deep Vein Thrombosis (DVT), researchers have
pointed towards association between recurrent DVT and absent IVC
The best use of systemic corticosteroids in the intensive care units, reviewMuhammad Asim Rana
Corticosteroids are one of the most common medications that are used in the intensive care units (ICUs);
corticosteroids are used for a variety of indications, including septic shock, acute respiratory distress syndrome
(ARDS), bacterial meningitis, tuberculous meningitis, lupus nephritis, severe chronic obstructive pulmonary disease
(COPD) exacerbations and many others.
Corticosteroids are associated with many severe side effects that affect morbidity and mortality of the patients like
increased risk of infections, glucose intolerance, hypokalemia, sodium retention, edema, hypertension, myopathy
etc. In order to make the best use of these medications and to minimize the unwanted side effects we should follow
some particular protocol. Please keep in our mind that there is controversy about dosing and tapering of steroids, so
effort has been made to include the best available evidence.
This review discusses mainly the most common indications of corticosteroids in ICU, dosing of corticosteroids in
those indications and how to taper corticosteroids according to the best evidence that recommends their use.
Literature search was done using Medline, BMJ, Uptodate, Chochrane database, Google scholar and the best
evidence based guidelines in which steroids are recommended to treat ICU related disorders. Sex hormones are not
discussed in this review since its use is rare in the intensive care units.
A very effective, precise and focused presentation for Calcium abnormalities and approach towards management. Targeted to teach the to the point diagnosis and treatment.
It is requested to download the presentation to run the animation as it is a very interactive presentation
A detailed discussion and description on fungal diseases and management. The focus is kept on those facts which frequently come across an intensivist but it is also important for the Internist.
A simple presentation on hypokalemia. The most common electrolyte disorder in the Critical Care practice.The presentation is based on a mortality and morbidity case report and discussion. It covers all the basic aspects of understanding the causes of hypokalemia in ICU and its management. Target audience are residents ICU and ER but all health care workers can benefit.
A detailed discussion on a very much in demand topic. Covered all aspects of the procedure which are important for an Emergency, Medical and Intensive Care physician should know. Nurses can also benefit from the presentation as we have tried to keep it as simple and straight forward as possible.
Transorbital stab injury with retained knife. A narrow escapeMuhammad Asim Rana
An interesting case report about a patient who was admitted with a 13 cm long knife stabbed in his eye and has gone across the mid line. The interesting thing to note is that patient did not develop any neurological deficit.
Multi drug resistant bacteria are a big problem in ICUs now a days. This is a successful case report where we treated an pleural infection b directly instilling the drug colistin in the pleura.
A simple description of a less understood topic in Intensive Care Medicine. Aim to make understanding and management easy for the residents and prevention steps for all ICU workers.
A brief yet comprehensive description of a very common problem faced in KSA especially during hajj season. It is meant to enhance the awareness among ER and ICU physicians.
Read| The latest issue of The Challenger is here! We are thrilled to announce that our school paper has qualified for the NATIONAL SCHOOLS PRESS CONFERENCE (NSPC) 2024. Thank you for your unwavering support and trust. Dive into the stories that made us stand out!
How to Split Bills in the Odoo 17 POS ModuleCeline George
Bills have a main role in point of sale procedure. It will help to track sales, handling payments and giving receipts to customers. Bill splitting also has an important role in POS. For example, If some friends come together for dinner and if they want to divide the bill then it is possible by POS bill splitting. This slide will show how to split bills in odoo 17 POS.
Ethnobotany and Ethnopharmacology:
Ethnobotany in herbal drug evaluation,
Impact of Ethnobotany in traditional medicine,
New development in herbals,
Bio-prospecting tools for drug discovery,
Role of Ethnopharmacology in drug evaluation,
Reverse Pharmacology.
The French Revolution, which began in 1789, was a period of radical social and political upheaval in France. It marked the decline of absolute monarchies, the rise of secular and democratic republics, and the eventual rise of Napoleon Bonaparte. This revolutionary period is crucial in understanding the transition from feudalism to modernity in Europe.
For more information, visit-www.vavaclasses.com
Students, digital devices and success - Andreas Schleicher - 27 May 2024..pptxEduSkills OECD
Andreas Schleicher presents at the OECD webinar ‘Digital devices in schools: detrimental distraction or secret to success?’ on 27 May 2024. The presentation was based on findings from PISA 2022 results and the webinar helped launch the PISA in Focus ‘Managing screen time: How to protect and equip students against distraction’ https://www.oecd-ilibrary.org/education/managing-screen-time_7c225af4-en and the OECD Education Policy Perspective ‘Students, digital devices and success’ can be found here - https://oe.cd/il/5yV
The Art Pastor's Guide to Sabbath | Steve ThomasonSteve Thomason
What is the purpose of the Sabbath Law in the Torah. It is interesting to compare how the context of the law shifts from Exodus to Deuteronomy. Who gets to rest, and why?
2. Why focus on infection
prevention and control in
critical care?
3. Intensive care units (ICUs) 10 %of total
beds, more than 20 percent of all
nosocomial infections are acquired in ICUs.
ICU-acquired infections account for
substantial morbidity, mortality, and
expense.
Improving infection prevention and control
in critical care acts as a catalyst for
improvement in the rest of the hospital.
4. Factors contributing in infections
1.
Compared to general patients,
patients in ICUs have more chronic
comorbidities & more severe acute
physiologic derangements.
2.
The high frequency of use of catheters
provide a portal of entry of organisms into
the bloodstream.
3.
Multidrug-resistant pathogens
MRSA and VRE are being isolated with
increasing frequency in ICUs
5. Studies of ICU-associated infections
Most studies of ICUassociated infections come
from industrialized countries,
The rates of infection may even be
higher in developing countries as
illustrated by a
multicenter,
prospective
cohort surveillance study of 46 hospitals
in Central and South America, India,
Morocco, and Turkey.
6. (as reported by NNIS)
Ventilator associated pneumonia (VAP)
CVL-related bloodstream infections
24.1 cases per 1000 ventilator days (10.0 - 52.7)
12.5 cases per 1000 catheter days ( 7.8 - 18.5)
Catheter-associated urinary tract infections
8.9 cases per 1000 catheter days
(1.7 - 12.8)
7. NNIS USA 1999 Antimicrobial Resistance
VRE : 24.7 % of enterococci isolates
MRSA: 53.5 % of S. aureus
ESBL :
10.4 % Klebsiella
3.9 % Escherichia coli
Pseudomonas aeruginosa
16.4 % resistant to imipenem
23.0 % resistant to fluoroquinolones
8. Risk Factors
Presence of underlying comorbidities
diabetes, renal failure, malignancies
predispose patients to colonization and infection with
multidrug-resistant bacteria.
Presence of indwelling devices
central venous catheters, Foley catheters, and
endotracheal tubes
which bypass natural host defense mechanisms and
serve as portals of entry for pathogens.
9. Risk Factors
Frequent manipulations and contact with
HCWs
usually concurrently caring for multiple ICU
patients
hands are the vehicles for transfer of pathogens
from patient to patient.
Long hospital courses prior to the ICU
admission, More Antibiotic Exposure ,…..
10. Outcome of MDR ICU infections
1.
Infections caused by MDR pathogens are
associated with
1.
2.
3.
2.
increased mortality,
Increased length of hospital stay,
increased hospital costs.
Patients with infections due to MDR organisms usually are chronically or acutely
ill and at risk of dying from underlying
serious and complex medical illnesses.
11. Prevention of MDR Infection
in the ICU
Two Major Strategies
1.
Strategies that attempt to improve the
efficacy and utilization of antimicrobial
therapy.
2.
Infection Control Measures
12. Outline on
Antibiotic utilization controls
1.
2.
3.
4.
5.
6.
Antibiotic evaluation committees
Protocols and guidelines to promote
appropriate antimicrobial utilization
Hospital formulary restrictions of broadspectrum agents
Substitution of narrow-spectrum antibiotics
Mandatory consultations with infectious
diseases specialists
Antibiotic cycling
14. General principles of infection control
Infection control
a discipline that applies epidemiologic and scientific
principles and statistical analysis to the prevention or
reduction in rates of nosocomial infections.
Effective infection control programs
proven to reduce the rates of nosocomial infections
and to be cost-effective.
Infection control is a key component of the
broader discipline of hospital epidemiology.
15. Achieving the main goal of
preventing or reducing the risk of
hospital-acquired infections
Where to focus energy for impact
16. Functions and Responsibilities of a
hospital Infection Control program
Education
Prevention of infections (eg, by hand hygiene)
Prevention of infections due to devices
disposal of infectious waste
Development of infection control policies and
procedures
Surveillance : (hospital-wide Vs. targeted)
Outbreak investigations
17. Functions and Responsibilities of a
hospital Infection Control program
Evaluation of devices used
Cleaning, disinfection, and sterilization of
equipment
Oversight on the use of new products that
directly or indirectly relate to the risk of
nosocomial infections
Review of antibiotic utilization and its
relationship to local antibiotic resistance
patterns
18. Functions and Responsibilities of a
hospital Infection Control program
Hospital employee health
Pre employment assessment
After exposure to either blood borne or
respiratory pathogens
19. Areas of Infection Control
Four major areas of infection control will
be reviewed here:
1.
Standard precautions, including hand
hygiene
Isolation precautions
Cleaning, disinfection, and sterilization
Surveillance
2.
3.
4.
20. STANDARD PRECAUTIONS
Various forms of isolation have been used
in an attempt to reduce the spread of
nosocomial infections.
In 1996, the CDC and Hospital Infection
Control Advisory Committee (HICPAC)
issued a new system of isolation
precautions.
25.
Standard precautions are recommended in
the care of all hospitalized patients.
The category of standard precautions
combines the important features of
body substance isolation policies and
universal precautions,
in so doing,
aims to reduce the risk of transmission of
infectious agents between patient and
healthcare worker.
26.
Standard precautions apply to
blood,
all body fluids,
nonintact skin,
mucous membranes and
secretions
and excretions
except sweat.
27. They entail
Handwashing before and after every
patient contact
The use of gloves, gowns and eye
protection in situations in which exposure
to body secretions or blood is possible
Handwashing after gloves are removed
The safe disposal of sharp instruments
and needles in impervious containers
The placement of soiled linens in
impervious bags and bloody or
contaminated materials such as feces or
urine in sanitary toilets
28. The 2007 CDC guidelines included
several additional components
Safe injection practices.
Use of a mask when prolonged procedures
involving puncture of the spinal canal are
performed
myelography,
epidural anesthesia,
injection of chemotherapeutic agents.
Respiratory hygiene/cough etiquette
29. Ignaz Philipp Semmelweis
Hungarian physician (1847)
incidence of puerperal fever
(Lack of hand washing by clinicians)
Hand dips with chlorinated lime at Vienna
General Hospital.
These ideas evolved to form current
guidelines
Hand cleansing opposed to Hand washing
30. Hand Hygiene
The surface of the skin is home of
bacteria and fungi,
Resident flora
Transient flora
Eradicating microbes on the hands of hospital
personnel is one of the holy crusades of
infection control
It is the single most important measure to
reduce transmission of microorganisms
from one person to another or one site to
another on the same patient.
32. Cleaning vs Decontamination
The removal of microbes from the skin is
known as decontamination,
requires the application of agents that have
antimicrobial activity.
Antimicrobial agents that are used to
decontaminate the skin are called antiseptics,
while those used to decontaminate inanimate
objects are called disinfectants.
39. Evidence for the efficacy of hand hygiene
Comparative
effects of a 6minute hand
scrub with 0.75%
povidone-iodine
and 4%
chlorhexidine
gluconate on
microbial growth
on the hands.
Bacterial counts
are expressed as
log base 10
40. Finger Nails
Much of the resident microflora of hands is found in
the periungual and subungual areas, and fingernails
are often neglected during routine hand cleansing.
When the fingernails are long and when artificial
fingernails are worn, there is an increase in
periungual colonization with a variety of pathogens
Guidelines from the CDC and Association of
Operating Room Nurses (AORN) prohibit the use of
artificial fingernails or extenders by health care
workers
41. Rings
There is no consensus on the need to
prohibit the wearing of rings in healthcare
settings even though several studies have
shown that skin beneath rings is more
heavily colonized with bacteria than
adjacent skin not covered by rings
42. Gloves
Three important reasons
To provide a protective barrier for the hands.
To reduce the acquisition of microorganisms
from a patient.
To reduce the transmission of microorganisms
from the hands of hospital staff to patients.
However, wearing gloves does not replace the need for hand washing
43. Masks
Three purposes in infection control
To protect healthcare personnel from
infectious material from patients.
To protect healthcare personnel from
infectious material from patients.
To protect healthcare personnel from
infectious material from patients.
Masks should not be confused with particulate respirators that are
used to prevent transmission by airborne droplet nuclei of
infectious agents such as M. tuberculosis.
44. ISOLATION PRECAUTIONS
Three isolation categories
Contact:
Contact precautions should be used in the care of patients with
multidrug-resistant bacteria, and various enteric, parasitic, and viral
pathogens.
Droplet:
Droplets are particles of respiratory secretions larger than 5
micrometers.
Airborne spread:
Airborne droplet nuclei, in contrast to larger droplets in the preceding
section, are particles of respiratory secretions smaller than 5
micrometers.
45. Droplet Precautions
Large Droplets(>5microns)
Haemophilus influenza (type b)
Epiglottitis,pneumonia,meningitis
Place patient in a
private room, if
unavailable patient
should not be within 3
feet of non infectious
patients
Hospital staff and
visitors should wear a
surgical mask within 3
feet of the patient
Neisseria meningitidis
pneumonia & meningitidis
Bacterial respiratory infections
Diphtheria
Mycoplasma
Group A strep pneumonia
Viral Respiratory Infections
Influenza
Adenovirus
Mumps
Rubella
46. Airborne Precautions
Small Droplets (<5micron)
Mycobacterium TB
Measels
Varicella (including
dissemenated Zoster)
Place patient in negative
pressure isolation room
Hospital staff and visitors
should wear N95 respirator
Those who are without a
history of infection or pregnant
ladies, immunocompromised
should not enter the room,
others should wear N95
47. ENVIRONMENTAL CLEANING
Cleaning
Cleaning is the removal of all foreign material (eg,
soil, organic material) from objects. It is normally
accomplished with water, mechanical action, and
detergents or enzymatic products.
Disinfection
Disinfection describes a process that eliminates many
or all pathogenic microorganisms from inanimate
objects, except for bacterial spores.
48.
Sterilization
Sterilization is the complete elimination or
destruction of all forms of microbial life by
Steam under pressure
Dry heat
Low temperature sterilization processes
(ethylene oxide gas, plasma sterilization)
Liquid chemicals
49. SURVEILLANCE
Cornerstone of all successful hospital
infection control programs.
Surveillance is only the starting point and
benchmark for assessing the need for
intervention strategies.
Effective surveillance involves
counting cases and then
calculating rates of various infections,
analyzing these data,
reporting the data in an appropriate way to personnel
involved in patient care
51. INTRODUCTION
Vancomycin-resistant enterococci (VRE)
are an increasingly common and difficult to
treat cause of hospital-acquired infection.
2006 report from the Clinical and
Laboratory Standards Institute
Vancomycin susceptible — ≤ 4 mcg/mL
Vancomycin resistant — ≥ 32 mcg/mL
An MIC of 8 to 16 mcg/mL was considered
vancomycin intermediate
52. TRANSMISSION
VRE colonize the gastrointestinal tract and
can be found on the skin due to fecal
shedding.
Colonization with VRE generally precedes
infection, but not all patients with
colonization become infected.
Persons either colonized or infected with
VRE can serve as sources for secondary
transmission.
53.
Transmission can occur by both
Direct contact (eg, the hands of health care
workers)
Indirectly
From
instruments eg, rectal probes
From environmental surfaces.
The following observations come from
different studies that have evaluated VRE
transmission:
54.
In a study in which VRE were inoculated in
different places, the strains survived for
Five to seven days on patients tables
24 hours without a reduction in counts on bedrails
60 minutes on a telephone handpiece
30 minutes on the diaphragmatic surface of stethoscopes
55. RISK FACTORS
Previous antimicrobial therapy
Patient characteristics
Colonization pressure
Exposure to contaminated surfaces
Residence in long-term care facilities
56. INFECTION CONTROL
Prevention of infection with VRE, requires a multifaceted
approach including
General infection prevention (eg, optimal management
of vascular and urinary catheters)
Accurate and prompt diagnosis and treatment,
Prudent use of antimicrobial drugs,
Prevention of transmission
57. Healthcare Infection Control Practices Advisory
Committee (HICPAC) guideline recommendations
Hand hygiene (Grade 1A)
Contact precautions (Grade 1A)
Cohorting (Grade 1A)
Not to attempt Decolonization (Grade 1B)
Surveillance cultures
Not applicable everywhere
three negative stool/rectal cultures obtained at weekly intervals are required to remove a
previously colonized patient from contact precautions if patient is not on antimicrobials
59. INTRODUCTION
The genus Acinetobacter consists of
ubiquitous Gram negative bacilli that were
originally identified in the 1930s
Gram negative coccobacilli
non-motile, strictly aerobic, catalase-positive,
and oxidase-negative.
60. PREVENTION AND CONTROL
In an era of
rising antimicrobial resistance rates
and limited therapeutic options,
the control of multidrug resistant pathogens
such as Acinetobacter relies heavily upon
preventive measures
61. Infection control
Apply standards precautions
at all times in contact with any patients
Apply contact precautions with MDRO infected patients
Use antibiotics appropriately
In the setting of an outbreak :
should be careful adherence to infection control measures.
1.
Compliance with hand hygiene and should be strictly enforced.
2.
Colonized and infected patients should be isolated or cohorted
3.
Contact precautions should be used consistently.
62. Infection control (Continued)
In the setting of an outbreak :
Environmental surfaces
1.
should be appropriately cleaned with an approved hospital
disinfectant.
Equipment that comes in contact with mucous membranes
or nonintact skin (semi-critical items)
2.
should undergo high level disinfection.
Proper investigations should be conducted
3.
•
•
attempt to identify a common source of infection
to prevent further dissemination of the infecting strain
64. INTRODUCTION
Prevention and control of methicillin-resistant Staphylococcus
aureus (MRSA) cross-infection
Some European countries have managed to contain MRSA at
a low prevalence Netherlands, Finland, and France
the most important challenges of infection control.
using active surveillance cultures
contact precautions
with or without decolonization
Other countries:
Germany and Canada
did not implement early MRSA surveillance and control measures
subsequently have struggled to control MRSA epidemics
65. SURVEILLANCE AND PRECAUTIONS
High MRSA prevalence has been
correlated with inadequate adherence to
infection control principles; (the countries with
greatest MRSA prevalence include the United States and Japan.)
Active surveillance cultures (ASC)
facilitate identification of patients with MRSA
colonization to be placed on contact
precautions
The goal is to minimize MRSA spread to other
patients.
66. Active surveillance cultures (ASC)
In the setting of hospital outbreaks
Among patients at high risk for MRSA
infection, such as
patients in intensive care units (ICUs),
immunocompromised patients,
long-term care facility residents,
Patients on hemodialysis
Patients with history of MRSA colonization
Patients hospitalized in the previous twelve months
Received antibiotic therapy in the last three months
Patients with skin or soft tissue infection at admission
67. Prevention & Control
HAND HYGIENE
ENVIRONMENTAL CLEANING
ANTIBIOTIC STEWARDSHIP
COMMUNITY PREVENTION
INFORMATION FOR PATIENTS
68. So far today…
I’ve changed 24 beds.
Dressed 25 wounds.
Emptied 20 bedpans.
Washed and dressed 16 patients.
Given 6 enemas.
Bandaged 3 sores.
Helped 10 people in toilet.
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