Download - Hospital Aquaired Infections
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HOSPITAL ACQUIRED INFECTIONS.
Prepared By Dr. Anees A. AlSaadi
Medical Resident R1.
20.1.2011
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INTRODUCTION :
Definition :
Are Group of infections.
No evidence of incubation on admission.
Caused by Variety of organisms.
Could be acute OR chronic.
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BURDEN :
Nosocomial infections are widespread.
They are important contributors to morbidity and mortality.
Cost either directly or indirectly.
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BURDEN CDC :
1.7 million infections.
99,000 associated
deaths each year.3
5% of all hospitalizations in the US.
WHO: 8.7% of hospitalized
patients had (HAI).
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WHAT ARE THE MOST
COMMON INFECTIOUSE
AGENTS ….. ?
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INFECTIOUS AGENT:
( MRSA).
Tuberculosis.
Invasive group A streptococcal infections .
Influenza.
Clostridium difficile diarrhea .
Scabies .
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RESERVOIR:
Humans either the staff or the
patients and medical associated
procedures and environment are
the usual reservoirs in this case.
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PORTAL OF EXIST: PORTAL OF ENTRY :
It is variable . It could be through:
Respiratory discharges e.g. influenza viruses.
Stool e.g. Rota virus and adenoviruses.
Skin e.g. Scabies .
Genito urinary
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MOOD OF TRANSMISSION :
All means of transmission being involved
Except : Soil contact Vertical.
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Host susceptibility
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HOST SUSCEPTIBILITY :
Age.
• Neonates.• elderly
patients
Gender.
• No predominance.
Occupation.
• Intensive care units.
• Emergency department.
• Laboratory medicine..
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HOST SUSCEPTIBILITY :General medical
condition:• Chronic ill patients.
• Immunocompromised.
• Long term medical devices .
• Long term antibiotics
• Bedridden state.
• Low activities .
Environmental factors:
• Variety of medical procedures.
• Invasive techniques creating potential routes of infection.
• Drug-resistant bacteria.
• Crowded hospital populations.
• Poor infection control practices .
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CLINICAL FEATURES :
Pneumonia.
Infectious diarrhea and foodborne illness.
Septicemia.
UTI .
Decubitus ulcers .
Conjunctivitis.
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DIAGNOSIS AND TREATMENT :
Diagnosis is clinical scenario oriented .
Cultures for blood, urine, stool and even sputum samples.
Viral serology should always be considered.
Treatment is case oriented . But the initial must be empirical and wide spectrum coverage.
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PREVENTION :
General Measures:
Health education: Not only to the patient or visitors but
medical staff also.
Educate the medical staff about (HAI) mood of transmission . ect.
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Hand washing is very important issue .
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PREVENTION Health promotion:
Provide the facilities for hand washing and personal hygiene.
Ideal settings to prevent blood diseases transmission.
Facilitate no crowding .
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PREVENTION ENVIRONMENTAL Safe water supply .
Prober disinfection.
Sanitary disposal of waste .
Food sanitation and food handlers control..
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PREVENTION ENVIRONMENTAL
Dust control .
Control of respiratory droplets .
Regular instrumental sterilization.
Usage of disposal instruments.
Blood and its products screening.
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PREVENTION
Administrative measures:Control infection committee :
To formulate the policies for infectious cases admission.
Coordinate all infection control facilities.
Formulates a medical staff rule when being ill.
Formulate rules for the visitors to the hospitals.
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PREVENTION : SPECIFIC MEASURES: Vaccination :
All staff should be vaccinated for the most common organisms .
Chemoprophylaxis :This is applicable in some situations like
in case of T.B contacts like nurses where INH must be given .
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CONTROL :
Cases : Early case finding .
Notification :
Isolation : Many infections must be isolated like (active open T.B, MRSA ….ect. )
Disinfection : all patients secretions, fluids ect. Must be ideally disinfected.
Treatment.
Release .
( HIV, Hepatitis, Meningitis, T.B ) are of A level .
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CONTROL : CASES :
Rehabilitation : so important for both the inpatient and even the medical staff whom become infected by what ever organisms as
(HAI) psychological rehabilitation and reassuring is essential as the medical
rehabilitation.
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CONTROL :CONTACTS :
The general rule is applied depending on the case.
Enlistment.
Surveillance for early case finding and testing it by prober laboratory investigation.
Immunization or chemoprophylaxis if applicable.
Treatment is applicable.
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ENVIRONMENTAL HAZARDS CONTROL:
Safe water supply .
Prober disinfection.
Sanitary disposal of waste .
Food sanitation and food handlers control.
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ENVIRONMENTAL HAZARDS CONTROL:
Dust control .
Control of respiratory droplets .
Regular instrumental sterilization.
Usage of disposal instruments.
Blood and its products screening.
Collaborating .
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THANK YOU !