HOSPITAL INFECTION

CONTROL
INFECTION

➢ the state or condition in which the body or part of the body is invaded by a
pathogenic agent (bacteria, virus, parasites etc.) which under favorable
conditions multiplies and produces injurious effects

NOSOCOMIAL INFECTION

➢ latin word “nosocomium” meaning hôspital

➢ synonymous to hospital-acquired infection
➢ infection acquired 48 hours after admission to hospital (not present or
incubating at the time of admission)
➢ acquired while in the hospital and developed after discharge

Common Sites of Nosocomial Infections

➢ Urinary tract
➢ Respiratory tract
➢ Gastrointestinal
➢ Blood stream
➢ Skin, Wound, Burn
➢ Surgical wound infection
➢ Others

Factors Promoting Nosocomial Infection

➢ age
➢ duration of hospitalization
➢ surgery (type of operation)
➢ immune status: chemotherapy, radiation therapy, malignancy
➢ diagnostic technique/ procedures
➢ environment
➢ personnel
➢ patient

THE PERSONNEL “COST” of Nosocomial Infection

➢ Need for hospitalization

➢ Income loss
○ Pain and suffering
○ Disfigurement/Disability
○ Death
 The INSTITUTIONS “COST” of Nosocomial Infection

➢ Loss of revenue
➢ Extra duty
➢ Liability insurance
➢ Malpractice
➢ Reputation

Sources of Agents of Nosocomial Infections

EXOGENOUS

➢ Hands
➢ Instruments
➢ Catheters
➢ Respiratory equipments
➢ Transfusions
➢ IV system
➢ Linen
➢ Air

ENDOGENOUS

➢ Oropharynx
➢ Respiratory
➢ Gastrointestinal
➢ Skin

Factors Promoting Endogenous Infections

MEANS OF TRANSMISSION
OF NOSOCOMIAL INFECTIONS

CONTACT
➢ Direct Contact
○ occurs when one person touches another
○ direct contact is an ongoing process in the hospital
○ best vehicle : Hands
➢ Indirect Contact
○ occurs when a person touches an inanimate object
contaminated by an infected patient
Factors that Increase Host Susceptibility to Nosocomial Infections

➢ Chronic underlying diseases

➢ Immune deficiency states
➢ Malignancies
➢ Therapeutic measures
➢ Immunosuppression
➢ Antibiotic therapy
➢ Invasive devices
➢ Surgery
➢ Age

BASIC PRINCIPLES IN INFECTION CONTROL

✔ The hands should be washed after handling infectious materials (e.g. bed
linen, dressings, secretion and excretions).
✔ The skin of the patient should be disinfected before invasive procedures
✔ Emphasize HANDWASHING for personal hygiene
✔ Rational Use of Devices
✔ Avoiding or removing factors that impair host defenses.
✔ Invasive devices should be avoided or should be removed as soon as possible
✔ Isolation Techniques based on method of spread
✔ Protective or Reverse Isolation
○ Rationale: decreasing the contact of the immunocompromised host to
potential pathogens
✔ Immunotherapy, Immunizations and other methods of reconstituting patient’s
immune response may be attempted
✔ The environment should be HOSTILE to the multiplication of pathogens, i.e.
clean, dry, exposed to light and well ventilated.
✔ All infectious materials (e.g. linen, clinical waste, sharps) should be safely
contained, decontaminated or destroyed.
✔ All instruments and equipment should be clean and dry. Invasive items
should be sterilized and items in contact with mucous membranes, body
fluids and potentially infectious materials should be disinfected.
✔ Food should be hygienically
○ prepared, properly cooked and
○ stored at low temperatures until
○ used.
✔ Susceptible patients or sites should be protected from pathogenic
microorganisms: i.e. aseptic technique practice during wound dressing, or
procedures
✔ Use of disposable supplies and equipment in an attempt to limit the spread of
infection by this means
✔ Control of insects and rodents that serve as vectors in the spread of
microorganisms
✔ The Health Care Worker (HCW) should be aware of how infection is
transmitted and the factors involved in the process
✔ The HCW should be able to implement the MOST effective and applicable
measures to prevent and control infection in his place of work
✔ The HCW should have the proper attitude of infection control