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Hospital Infection

Hospital Infection. Nosocomial infection. Hospital acquired infections . Nosocomial infections are those that originate or occur in a hospital or hospital-like setting. Nosocomial infections are responsible for about 20,000 deaths in the U.S. per year.

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Hospital Infection

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  1. Hospital Infection Nosocomial infection

  2. Hospital acquired infections • Nosocomial infections are those that originate or occur in a hospital or hospital-like setting. • Nosocomial infections are responsible for about 20,000 deaths in the U.S. per year. • Approximately 10% of hospital patients acquire a clinically significant nosocomial infection.

  3. Classification • CAI → hospital admission (pneumonia) • Admission → infection (device-associated bacteraemia) • Discharge → infections (Surgical site infection) • Infection to hospital staff (Hepatitis B infection)

  4. Why hospital infections • High prevalence of pathogens • More compromised hosts • Efficient mechanisms of transmission from patient to patient

  5. Presence of pathogens • Nosocomial infections are primarily caused by opportunists , particularly b: • Enterococcus spp. • Escherichia coli • Pseudomonas spp. • Staphylococcus aureus

  6. Sites of nosocomial infections • Most to least common: • Urinary tract • Surgical wounds • Respiratory tract • Skin (especially burns) • Blood (bacteremia) • Gastrointestinal tract • Central nervous system

  7. Hospital microorganisms tend to acquire antibiotic resistance factors

  8. Normal microflora of HCW • Pathogens become incorporated into the normal flora of hospital workers • Nosocomial pathogens tend to be: • Available for transmission to patients • Not easily treated

  9. Compromised hosts • Infants and elderly • Pre- existing diseases • Immuno-suppressive • Radio therapy or Chemo therapy • Splenectomy • Broken skin and mucous membranes • Surgery, insertion of catheters, tracheostomy, ventilators, …etc.

  10. Chain of transmission • Many sick patients under one roof • More efficient transmission

  11. Modes of transmission • Direct person-to-person transmission: • Infected patient, staff member, or visitor • Indirect transmission through: • Equipment, supplies and hospital procedures • Transmission through air

  12. Routes of transmission • Air-borne • Contact spread (direct or indirect) • Food-borne spread • Blood-borne spread (injuries or transfusion) • Self-infection and cross-infection

  13. Prevention • The infection control policy • Staff training and education • Cleaning, disinfection and sterilization • Aseptic techniques • Prophylactic antibiotics

  14. Prevention • Protective clothing • Isolation of dangerous patients • Hospital building and design • Equipment • Microbiology surveillance

  15. Control measures to reduce exogenous hospital acquired infection

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