Downloaded 41 times
More Related Content
Similar to Nosocomial infection
Nosocomial infection
- 1. PREVENTION OF HOSPITALACQUIRED INFECTION Presented by Group 1 Candidates of (HA&HM) Dr ye wint kyaw Dr Nay Win Aung Dr Pyae Son Htoo Dr Min Banyar Chan Ei Dr Zaw Lin
- 2. The termnosocomial is derived from the Greek words nosos, meaning "disease." and komeo, meaning "to take care of." Hospital Infection
- 3. Hospital Infection Hospital Associated Infection Hospital Acquired Infection Nosocomial Infection Health Care Associated Infection
- 4. DEFINITION OF HAI(NOSOCOMIAL INFECTION) Infections that arise in hospital Infection neither present nor incubating at the time of admission Infection that develops in patients after more than 48 hours of hospitalization May appear after discharge from hospital Also apply to infections among health care workers and visitors following exposure in health care settings. Any infection acquired in hospital and developing in the hospital or becoming clinically apparent after discharge of patient.
- 5. PUBLIC HEALTH PROBLEMS 1.- increasing No. & crowding of people 2. - more frequent impaired immunity 3. - emergence of new micro organisms 4. - increasing bacterial resistance to antibiotics
- 6. IMPACT OF HOSPITALINFECTION 1. Longer hospital stay 2. Increased hospital costs for the patient 3. Problem of antibiotics resistance 4. Less qualitative utilization of hospital beds
- 7. INFLUENCING FACTORS OFHAI 1. Microbial agents 2. Patient’s susceptibility 3. Environmental factors 4. Antimicrobial resistance
- 8. AGENTS(MICROBIAL) Bacteria, viruses,fungi & parasites
- 9. HOST (PATIENTS) Patient’s Susceptibility 1.Age 2. Immune status 3. Underlying diseases 4. Diagnostic & therapeutic interventions
- 10. ENVIRONMENTAL FACTORS 1. Infectedpatients (or) carriers in hospital 2. Crowded conditions within hospital 3. Frequent transfers of patients 4. Concentration of patients highly susceptible to infections in one area
- 11. ANTIMICROBIAL RESISTANT BACTERIA 1. Increaseuse of antibiotics in hospital 2. Selection of resistant strains (eg.MDRTB) 3. Resistant bacteria emerge & spread in the health care setting
- 12. COMMON NOSOCOMIAL INFECTIONS 1.Urinary tract infection 2. Lower respiratory tract infection 3. Surgical wound infection 4. Bacteremia 5. Others – skin infection, gastroenteritis
- 13. Causal agentsof UTI 1. Escherichia coli – commonest 2. Proteus species 3. Klebsiella species 4. Pseudomonas aeruginosa 5. Staphylococccus saprophyticus 6. Staphylococccus aureus 7. Enterococcus faecalis
- 14. Causal agentsof SSI 1. indigenous flora 2. Staphylococcus aureus 3. coagulase-negative staphylococci 4. enterococci 5. gram-negative aerobic or facultative bacilli
- 16. 2. Viruses - HepatitisB & C viruses through transfusion, dialysis, injection & endoscopy - Respiratory syncytial virus (RSV), rotavirus & enteroviruses transmitted by hand-to- mouth contact and via the faecal-oral route - Other viruses such as Cytomegalovirus, HIV, Ebola, Influenza viruses, Herpes simplex virus, Varicella zoster virus & SARS CoV may also be transmitted
- 17. 3. Parasites andFungi - some parasites (eg. Giardia lamblia) transmitted easily among adults or children - many fungi & other parasites are opportunistic organisms - cause infections during extended antibiotic treatment & severe immunosuppression eg. - Candida albicans - Aspergillus spp. - Cryptococcus neoformans - Cryptosporidium spp
- 18. MRSA MRSA detectedin in the UK in 1961, only months after methicillin introduction Since then, MRSA has become a common cause of nosocomial infections worldwide In 1993, MRSA infections emerging in the community were reported methicillin- resistant Staph aureus (MRSA) which can resist practically almost all antibiotics they have arisen to the level of public health threat in both hospital-acquired & community-acquired infections These strains cause skin & soft tissue infections (SSTIs) and may occasionally cause severe sepsis & pneumonia or death in previously healthy patients.
- 19. STANDARD /UNIVERSAL PRECAUTIONS Basic levelof “standard” precautions involves work practices that are essential to provide a high level of protection to patients, health care workers and visitors (1) hand washing and antisepsis (hand hygiene) (2) Use of PPEs ( Personal Protective Equipment) (3) Safe injection practice; prevention of needle stick /sharp injuries (4) environmental cleaning and spills - management
- 21. USE OF PPES( PERSONAL PROTECTIVE EQUIPMENT) 1. Masks 2. Gloves 3. Others, caps, clothing, shoes, goggles ( for areas like ICU, Operation theater, aseptic units)
- 22. ADDITIONAL ( TRANSMISSION-BASED) PRECAUTIONS Additionalprecautions include: -airborne precautions -droplet precautions -contact precautions
- 23. AIRBORNE PRECAUTIONS Thefollowing precautions need to be taken: - Implement standard precautions - Place patient in a single room (negative pressure room) - Keep doors closed - Must wear a special, high filtration, particulate respirator (N 95) mask - Limit the movement & transport of the patient with a surgical mask
- 24. DROPLET PRECAUTIONS Diseaseswhich transmitted by this route, include pneumonias, pertussis, diphtheria, infleunza type B, mumps & meningitis Occurs when there is adequate contact between the mucous membrane of the nose & mouth or conjunctiva of a susceptible person & large particle droplets (> 5 microns) Droplets usually generated from the infected person during coughing, sneezing, talking ,or tracheal suctioning
- 25. CONTACT PRECAUTIONS Diseasestransmitted by this route include colonization or infection with multiple antibiotic resistant organisms, enteric infections, &skin infections - implement standard precautions - place patient in a single room or in a room with another patient infected by the same pathogen - wear clean non–sterile gloves when entering the room - wear a clean, non- sterile gown when entering the room if a substantial contact with the patient’s room is anticipated - limit the movement and transport of the patient from the room
- 26. NOSOCOMIAL INFECTION SURVEILLANCE Surveillanceis an effective process to decrease the frequency of hospital acquired infections The specific objectives of the surveillance programme include:- To improve awareness of the clinical staff other hospital workers (including administrators) about nosocomial infections & antimicrobial resistance To monitor trends: incidence, prevalence and distribution of nosocomial infections To evaluate the impact of prevention measures 1. Site oriented surveillance 2. Unit oriented surveillance 3. Priority oriented surveillance
- 27. INFECTION CONTROL MANUAL Should contain instructions & practices for patient care Should be developed & updated by ICT Reviewed & approved by the ICC Must be made readily available for healthcare workers Updated in a timely fashion
- 28. CONCLUSION Nosocomial infectionsare worth preventing in terms of benefits in morbidity, mortality, duration of hospital stay, and cost. Educational interventions promoting good hygiene and aseptic techniques have generally proved to be successful, but these practices are often not sustainable. In the end, constant vigilance and attention by the individual to what are rather simple measures is demanded.