INTRODUCTION TO INTRODUCTION TO INFECTION CONTROLINFECTION CONTROL

ICNOICNOInfection Control Unit,Infection Control Unit,

Teaching Hospital,Teaching Hospital,Jaffna.Jaffna.

What is infection control?What is infection control?

Infection control is a series of Infection control is a series of procedures and guidelines procedures and guidelines to prevent hospital to prevent hospital associated infection. [H.A.I]associated infection. [H.A.I]

Hospital acquired infectionsHospital acquired infections Acquired by patients during their stay in the Acquired by patients during their stay in the

hospitalhospital

Neither present nor incubating at the time the Neither present nor incubating at the time the patient was admitted to the health care facility and patient was admitted to the health care facility and may appear even after the patient is dischargedmay appear even after the patient is discharged

Symptoms appear usually 48-72 hours after Symptoms appear usually 48-72 hours after admissionadmission

Sources of infectionsSources of infections Endogenous – due to organisms in own flora. Endogenous – due to organisms in own flora. Eg: group B streptococcal infectionsEg: group B streptococcal infections

Exogenous – infections acquired from Exogenous – infections acquired from outside.outside.

(Cross infections/HAI)(Cross infections/HAI) -Infected or colonized patients/staff -Infected or colonized patients/staff -Contaminated equipment/ medication-Contaminated equipment/ medication -Environment – surfaces, air, food, water-Environment – surfaces, air, food, water

44

HAI – Why is it a problem?HAI – Why is it a problem?

Caused by hospital bacteria – Resistant to Caused by hospital bacteria – Resistant to commonly used antibioticscommonly used antibiotics

Eg:- MRSAEg:- MRSA (methicillin resistant staphylococcus (methicillin resistant staphylococcus aurousaurous))

ESBLESBL (Extended-spectrum beta-lactamase)(Extended-spectrum beta-lactamase) Have to use expensive drugs in their treatmentHave to use expensive drugs in their treatment Duration of infection is usually longDuration of infection is usually long Higher mortalityHigher mortality Increased economic burdenIncreased economic burden Quality of lifeQuality of life Pain/suffering/ depressionPain/suffering/ depression

Types of HAITypes of HAI Urinary Tract InfectionsUrinary Tract Infections Respiratory Tract Infections – Respiratory Tract Infections –

ventilator associated pneumoniaventilator associated pneumonia Surgical site InfectionsSurgical site Infections SepticaemiaSepticaemia Skin & Soft tissue InfectionsSkin & Soft tissue Infections Meningitis -rareMeningitis -rare

Causative organismsCausative organismsGram negative bacilli- E.coli ,Gram negative bacilli- E.coli , - Klebsiella spp- Klebsiella spp - Serratia spp- Serratia spp - Acinetobacter spp- Acinetobacter spp - Pseudomonas spp- Pseudomonas spp Gram positive cocci – S. aureus (MRSA)Gram positive cocci – S. aureus (MRSA) - Enterococci (VRE)- Enterococci (VRE)Gram positive bacilli – Corynebacteria sppGram positive bacilli – Corynebacteria spp - Clostredium difficilli- Clostredium difficilliCandida sppCandida spp

Factors affecting HAIFactors affecting HAI Age – elderly & very young patientsAge – elderly & very young patients Underlying DiseasesUnderlying Diseases Invasive proceduresInvasive procedures Immunosuppression – Cytotoxic Immunosuppression – Cytotoxic

drugsdrugs Trauma , BurnsTrauma , Burns ImplantsImplants

Routes of Spread of Routes of Spread of InfectionsInfections

Contact – direct - handsContact – direct - hands - indirect via fomites- indirect via fomites Respiratory tract - air born particles <5Respiratory tract - air born particles <5µµ – – droplet particles >5droplet particles >5µµ Faeco–oral – food & waterFaeco–oral – food & water - poor hygiene- poor hygiene IV fluids & medicationsIV fluids & medications Blood & blood products Blood & blood products Sharp injuries -occupationalSharp injuries -occupational Splashes on to mucus membranes -Splashes on to mucus membranes -

occupationaloccupational

How are these infections How are these infections transmitted?transmitted?H.A.I may be transmitted H.A.I may be transmitted by health care workers to by health care workers to patients, from patient to patients, from patient to patient and from patient patient and from patient to health care workers.to health care workers.

Prevention of Hospital Prevention of Hospital InfectionsInfections

Many of these infection can be Many of these infection can be controlled following a set of very controlled following a set of very simple practical guidelines called simple practical guidelines called stranded precaution.stranded precaution.

Elimination of source of infectionElimination of source of infection Interruption of transmissionInterruption of transmission Enhancing the host ability to resist infectionEnhancing the host ability to resist infection

STANDARD PRECAUTIONSTANDARD PRECAUTION1.Hand hygiene1.Hand hygiene2.Use personal protective equipment 2.Use personal protective equipment

[PPE][PPE]3.Proper cleaning disinfection and 3.Proper cleaning disinfection and

sterilization of patient care equipment.sterilization of patient care equipment.4.Environmental cleaning and 4.Environmental cleaning and

disinfection when necessary.disinfection when necessary.5.Proper handling of linen.5.Proper handling of linen.6.Proper waste disposal.6.Proper waste disposal.7.Proper handing and disposal of sharps.7.Proper handing and disposal of sharps.8.Occupational Health8.Occupational Health

SPECIFIC MEASURESSPECIFIC MEASURES• Facilities for hand washing and dryingFacilities for hand washing and drying• Adequate spaceAdequate space• VentilationVentilation• Isolation facilitiesIsolation facilities• Health care workers with out infection.Health care workers with out infection.• Infection surveillanceInfection surveillance• Antibiotic policyAntibiotic policy• Liaison with infection control team Liaison with infection control team • Health education of staff, patients and Health education of staff, patients and

visitorsvisitors

THANK YOUTHANK YOU

ICNO ICNOInfection Control Unit,Infection Control Unit,

Teaching Hospital,Teaching Hospital,Jaffna. Jaffna.