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Nosocomial infections

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xom ibrahim

on 13 April 2015

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Transcript of Nosocomial infections

Prevention :
Risk factors
Types of Infections
Urinary Tract Infections


Blood Stream infections

Surgical site infections

Nosus = disease
Komeion = to take care of
Nosocomial = hospital acquired

Nosocomial infection
is specially one that
not present or incubating prior to the patients being admitted to the hospital but accuiring within
hours after admitance to the hospital.

1 out of 25 patients are infected by HIA
About 99000 patients die each year from HIA

Treatment from HIA cost hospital about 10 billion dollars a year
Invasive Procedures
Non-Modifiable Risk
Age :
Very young
Very old
Medical Conditions :
weak Immune system
Urinary Catheters
Venous Catheter
Respirotary Equipment :
Mechanical Ventilation
Surgical Incisions
Common Organisms causing infections
Bacteria : S.aureus , Protease , Klebsiella

Virus : Hepatitis B , C

Fungi : Candida
Other Risk Factors
Longer Hospital Stay
Poor Hygiene :
Hospital Staff
Urinary Tract Infections
Most common HAI

Usually accurs after urinary catheter is placed

Causes :
Garm (-) Entericbacteria
E.coli 50 %
Candida albican 14%
pseudomonous 13%

Poor Hygiene from health care providers and contaminated equipment (e.g mechanical ventilator neubulizer )

There are classifications for Nosocomial Pneumonia including :

1- Ventilator Accquired Pneumonia (VAP)
2- Hospital Accquired Pneumonia (HAP)
3- Healthcare Associated Pneumonia (HCAP).

Bloodstream Infection
Microorganisms can get into intravenous lines from the contamination of
surroundings, equipments, and healthcare providers.

Most common associated device : Central Venous Catheters

Cause is usually cutaneous Microflora
Coagulase (-) Staph (31%)
Staph Aureus (20%)
Enterococci (9%)
Surgical Site Infection
Surgery directly invades the body which can introduce microorganisms.

If there is contamination present during the surgery, infection at the site can occur.
Notable Microorganisms
MRSA ( Multidrug Resistant Staphylococcus aureus)

Risk Factors
: Prolonged Hospitalization, Antibiotic Use, Intensive Care and Invasive Devices.
Bacteria that colonizes the GI tract due to altered gut flora after antibiotic therapy.

Associated with : Fluoroquinolones , Cephalosporins , Carbapenems , and Clindamycin.
Clostridium Difficile
Contact transmission
1- Direct-contact transmission
Droplet transmission
Droplets containing microbes the host's body.

Droplets are generated from the source person mainly by :
coughing, sneezing, and talking, and during the performance of certain procedures,
such as bronchoscopy.
Airborne transmission
Dissemination can be either :
- Airborne droplet nuclei of evaporated droplets containing microorganisms
- Or dust particles containing the infectious agent.

Microorganisms carried in this manner may become inhaled by a susceptible host within the
same room
over a longer
distance from the source patient,

Microorganisms transmitted by airborne transmission :
Legionella, Mycobacterium tuberculosis and the rubeola and varicella viruses.
Common vehicle transmission
This applies to microorganisms transmitted to the host by contaminated items, such as
food, water, medications, devices, and equipment.
Vector borne transmission
This occurs when vectors such as
mosquitoes, flies, rats, and other vermin
transmit microorganisms.
Sterilization kills all microorganisms on equipment and surfaces through :
exposure to chemicals, ionizing radiation, dry heat, or steam under pressure.
Infectious patients must be isolated.

Gloves are worn for three important reasons in hospitals :

1- To provide a protective barrier and to prevent gross contamination of the hands .

2- To reduce the likelihood microorganisms present on the hands of personnel will be transmitted to patients .

3- To reduce the likelihood the hands of personnel contaminated with micro-organisms from a patient or a fomite can be transmitted to another patient.

Gloves must be changed between patient contacts

Wearing gloves does not replace the need for handwashing,
because gloves may have small, inapparent defects or may be torn during use, and hands can become contaminated during removal of gloves.

Surface sanitation
Modern sanitizing methods such as NAV-CO2have been effective against gastroenteritis, MRSA, and influenza agents.

Hydrogen peroxide
is effective against endospore-forming bacteria, such as Clostridium difficile.

Ultraviolet cleaning device
s may also be used to disinfect the rooms of patients infected with Clostridium difficile after discharge.
Antimicrobial surfaces
Touch surfaces such as :
bed rails, call buttons, touch plates, chairs, door handles, light switches, grab rails, intravenous poles, dispensers (alcohol gel, paper towel, soap), dressing trolleys, and counter and table tops are known to be :

Contaminated with
Staphylococcus, MRSA
(one of the most virulent strains of antibiotic-resistant bacteria) and v
ancomycin-resistant Enterococcus

A number of compounds can decrease the risk of bacteria growing on surfaces including: copper, silver, and germicides.
Wearing an apron during patient care reduces the risk of infection.
The apron should either be disposable or be used only when caring for a specific patient
 Hospital acquired infection is a serious risk for any patient visiting a hospital.

 It leads to more morbidity and mortality

 It is also an important reason for increased cost of treatment

 Care must be taken to prevent hospital acquired infections

By : Biinar Ibrahim
Zahra Ahmad
Roshna Mhamad

Affects about 1.7 million each year
30-50% of
HAI's are Preventable
Pneumonia is the largest cause of

of all hospital acquired infections (70% of all cases)

Most common associated device : Mechanical Ventilation

Gram Negative Bacteria (Pseudomonas, E. Coli, Klebsiella)
Staph Aureus

2- Indirect-contact transmission
Hospitals have sanitation protocols regarding uniforms, equipment sterilization, washing, and other preventive measures.

Despite sanitation protocol, patients cannot be entirely isolated from infectious agents.

Use of different kinds of soap, (normal and antiseptic), and alcohol-based gels.

The main problems found in the practice of hand hygiene is connected with :
the lack of available sinks and time-consuming performance of hand washing.

An easy way to resolve this problem could be the use of
alcohol-based hand rubs,
because of faster application compared to correct hand washing.

As of 2014, it is unclear whether or not nail polish or rings affected surgical wound infection rates

Patients are often prescribed antibiotics and other antimicrobial drugs to help treat illness; this may increase the selection pressure for the emergence of resistant strains.
Objectives :
Risk Factors
Common agents
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