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Health Care Associated Infections and Infection Control

Health Care Associated Infections and Infection Control. Terminology. Health Care Associated Infections – HCAIs Hospital Acquired Infections – HAIs Throughout history drastic decreases in mortality and morbidity have been made through advances in hygiene.

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Health Care Associated Infections and Infection Control

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  1. Health Care Associated Infections and Infection Control

  2. Terminology • Health Care Associated Infections – HCAIs • Hospital Acquired Infections – HAIs • Throughout history drastic decreases in mortality and morbidity have been made through advances in hygiene. • There still an awful lot of work to do.

  3. It is quite a problem. • HAIs are the most common hospital complication. • Costs and issues: • Morbidity and mortality • Increase in hospital stay • Cost of antimicrobial therapy • Reduced productivity • Insurance claims • Additional reservoir for the infection

  4. Statistics • 200,000 HAIs leading to 7000 deaths (2003). • $268 million per year for surgical site infection (2003). • $686 million per year for blood stream infections (2003). • 2 million bed days per anum (2003). • You’ll notice these are widely different to those in the summary. We’ve improved. • Most common HAIs • UTIs, surgical wounds, lower respiratory tract, skin, blood

  5. Causes • What bacteria have been responsible for HAIs have changed over the years. • Many infections are now due to resistant bacteria. • MRSA, VREF, ESBL, CDAD, VRSA, VISA etc • Viruses – norovirus, rotavirus, cytomegalovirus, herpes simplex, RSV • Fungi – candida, aspergillusfunigaus

  6. Staph • MRSA is endemic in many hospitals. • Strains with decreased sensitivity to vancomycin have been identified. • Lead us to VISA (vancomycin intermediate staph.) • Staph. Epidermidis • Many infections associated with IV lines, shunts, prosthetics. • Resistant strains are now common.

  7. VRE • Vancomycin resistant enterococci • Enterococci is already naturally resistant to a lot of drugs, leaving vancomycin as the only treatment available. • Incidence of infection is low, colonisation is common. • Exposure to broad spectrum antibiotics predisposes a person to infection. • VRE may transfer resistant to MRSA via plasmids.

  8. CDAD • Clostridium difficle associated diarrhoea. • Most common cause of hospital acquired diarrhoea. • Exposure to broad spectrum antibiotics predisposes a person to infection. • Common in the immunocomprimised. • Produces different to remove spores. • Resistant to clindamycin and quinolones

  9. Sources of infection

  10. Identifying Infection • Swab everywhere and anywhere. • Blood collection • Two sets different routes, some time period apart (30 minutes) • Each set used for anaerobic and aerobic cultures. • Be wary of contamination.

  11. Stopping Infection

  12. Australian Infection Control Guidelines • Australian Guidelines for the Prevention and Control of Infection in Healthcare (2010) • Nationally accepted approach to infection control. • Should be read by every healthcare worker. • Guidelines cover • Understanding of modes of transmission of risk management • Effective work practices that minimise the risk of transmission • Governance structures to monitor and regulate • Compliance with legislation

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