3. Definition
Hospital acquired infections are those which manifest in the
patient AT LEAST 48 HRS AFTER ADMISSION IN THE HOSPITAL,
which was neither present or incubating at the time of
admission.
• OLDER TERM – NOSOCOMIAL INFECTION.
4. An infection is a HAI if :
The patient was admitted for a reason other than this infection
Symptoms should appear 48 hours after admission
Infection was not present at the time of admission
Infections which manifest after discharge is also accounted under HAI
Occupational infections among staff of the hospital care facility
5. Factors affecting HAI
Immune status of the patient
Hospital environment
Hospital organisms (MDR)
Diagnostic/ therapeutic interventions
Transfusion of blood,blood products & IVF
Poor hospital administration
6. Sources of infection
Sources of infection
Endogenous
Exogenous
-Environmental souces (inanimate
objects)
-Health care workers (MDR carriers)
-Other patients
7. • Enterococcus faecium
• Staphylococcus aureus
• Klebsiella pneumoniae
• Acinetobacter baumannii
• Pseudomonas aeruginosa
• Enterobacter species
Major HAI pathogens : ESCAPE =
ESKAPE pathogens.
12. CAUTI-Catheter assoicated Urinary
tract infections
• Risk factors
• (1)advanced age
• (2) female gender
• (3) severe underlying disease
• (4) placement of a urinary cathete
• Organisms: Gram-negative rods -majority of hospital
acquired UTI’s
• -E. coli is number 1
• -S.aureus & Enterococci cause the remainder of the
infections
13. CLABSI-
Central line
associated
BSI
• Risk factors
Patient related-
o Age(<1 yr,>60yrs)
o Malnutrition
o low immunity
o Severe underlying disese
o loss of skin integrity(burn/bedsore)
o prolonged ICU stay
Device related- presence of central line
HCW related-poor infection control practices-
hand hygeine
16. SSI-Surgical
site
infections
• -Surgical site infections (SSI) are defined
as infections that develop at the surgical
site within 30 days of the surgery
• -(50%) of SSIs develop after discharge of
the patients from the hospital
• Organisms
oFor clean wound: The skin flora of surgery
team/ environmental organisms -most
common -S. aureus.
oFor other types: The patients endogenous
flora (anaerobes and gram-negative rods)
17. Risk factors
Advanced age,obesity, malnutrition, diabetes
Infections at a remote site that spread through
blood stream
Pre-operative shaving of the site
Inappropriate timing of prophylactic
antimicrobial agent
The antimicrobial prophylaxis is given 1 hour
prior to the incision, usually along with the
induction of Anesthesia.
19. Standard
precautions
-Set of infection control practices used to
prevent transmission of diseases that can be
acquired by contact with- blood, body fluids,
non-intact skin (including rashes), and mucous
membranes
-These measures should be followed when
providing care to:
• All individuals, whether or they appear
infectious/ symptomatic or not
• All specimens (blood or body fluids) whether
they appear infectious or not
• All needles and sharps whether they appear
infectious or not.
22. Hand hygiene
methods
Hand rub –
chlorhexidine 2 –
4%/ 70-80%
ethyl alcohol
Duration-20-30
sec
Adv : no drying
required
Disadv : visible
soiling – not
sufficient.
Hand wash –
soap & water
40 – 60 sec
duration
required.
23.
24.
25. Personal Protective Equipment
•Protection of skin & mucosa from exposure to blood
/ body fluids & from health care worker’s hands to
the patients.
•Selection of PPE based on level of risk associated in
standard precautions& presence of high risk of
transmission etc.
30. Spill management
• < 10 mL –wipe spill immediately
with adsorbent material,discard
• Wipe with 10% sodium
hypochlorite,allow to dry
• > 10 mL-place disposable paper
towels to adsorb the spill—Pour
10% hypo over the towels, leave for
15 mins.
Respiratory hygiene
• Cover mouth & nose – while
coughing, sneezing with single use
tissue paper
• If tissue paper is NA- inner elbow
• Hand hygiene
• Keep away from mucosa ( eyes &
nose)
• Masks,separate queue for infective
pts
• Sputum collection-open space/
well ventilated room
31. Specific precautions
•Additional precautions taken over the
standard precautions when a disease of a
specific mode of transmission is suspected.
•Taken when standard precautions – not
sufficient.
34. Components
of contact
precautions
:
1. Isolation
-Individual room optional,
-cohorting desirable
1. Restriction of patient movement
to a room ; transfer with hand
hygiene & PPE.
2. PPE and hand hygeine for staff
3. Separate equipment for isolated
patient – BP cuff, nebulizer,
stethoscope etc
4. Environmental cleaning
41. Functions of
HICC
• HAI Surveillance
• Develops a system for
identifying,reporting,analysing,investigating &
controlling HAI
• Antimicrobial stewardship program
• Policies and guidelines
• Education for HCW regarding HAI
• Staff health
• Outbreak management
• Communicates & cooperates with other depts.
• HICC meetings- not < 1/ month
• Reviews