maternal child health - grande international hospital

Maternal – Child Health

Learning objectives

1. Describe the role of infection prevention and control in maternal child health.

2. Identify potential infection risks in this setting.

3. Explain practices for prevention and control of infection for these patients.

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Time involved

• 60 minutes

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Key points• Infection prevention and control strategies based on the

principle of combined care

• For neonates requiring intensive care, the newborn’senvironment must be clearly delineated, with spatial separation between incubators

• Sharing of equipment and supplies must be preceded by thorough cleaning and appropriate disinfection/sterilisation

• Standard Precautions should be applied for all patient care

• Prevention strategies include hand hygiene, patient hygiene, environmental cleaning and immunisation

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Background• The World Health Organization (WHO)

estimates that approximately 210 million women become pregnant each year and that 529,000 die from complications

• In the immediate post-partum period, sepsis and haemorrhage are the commonest causes of maternal death

• Severe infections cause more than one-third of neonatal deaths

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Neonatal risk factors - 1

• Maternal infections

• Foetal gestational age at the time of the infection

• Complications of delivery

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Neonatal risk factors - 2 • Premature infants are at risk for infection due to:

• Absence of normal microbial flora• Increases the risk of colonisation with pathogens

• Colonisation by gastrointestinal flora • Risk differs between breast fed babies versus formula-fed

babies

• Abnormal colonisation that occurs most often in newborns in neonatal intensive care units

• Fragile, underdeveloped organs that normally provide a barrier to infectious pathogens• Such as the skin and lining of the lung

• A poor immune (antibody) response

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Neonatal infections

• Occur in the first 28 days of life

• May be spread:

• In utero• By the transplacental route

• Intrapartum• When in contact with the maternal genital tract, blood

or stool

• Postpartum• When in contact with the mother, family and visitors,

other neonates in the nursery, health care workers, or contaminated equipment

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Infant infections• For full term newborns - superficial infections of the

skin, eye and mucous membranes.

• Additional infections occur in intensive care

• Bacteraemia associated with central lines, pneumonia and gastrointestinal infections

• Microorganisms associated with neonatal infections

• Staphylococcus aureus, coagulase negative staphylococci, Group B streptococci, Escherichia coli and Candida

• Other pathogens often associated with outbreaks in the nursery • Klebsiella, Serratia, Enterobacter, Citrobacter and

Pseudomonas species

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Maternal Risk Factors

• Prolonged rupture of membranes (>24 hours)

• Obesity

• Interferes with wound healing

• Diabetes mellitus

• Invasive tests and procedures

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Maternal Infections• Common infections include:

• Endometritis• Infection of the lining and wall of the uterus (endometrium

and myometrium)

• Mastitis• Inflammation and infection of the breast

• Caesarean surgical site infections

• Episiotomy site infections• Infection at the site of incision of the perineum

• Sepsis• Bloodstream infection which causes a systemic inflammatory

response

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Prevention Strategies

• Standard Precautions

• Hand Hygiene

• Protective barriers

• Cohorting

• Additional precautions

• Single rooms

• Cleaning

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Standard Precautions

• Basic hygienic precautions are recommended for all patient encounters

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Hand Hygiene

• Use soap and running water or alcohol-based hand rubs:

• before and after contact • with the mother

• with the neonate

• with their immediate environment

• before an aseptic procedure

• after handling blood and body fluids

• after removal of gloves

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Protective barriers

• Gloves worn for all contact with mucous membranes, non-intact skin and moist body substances

• Masks and/or protective eyewear or face shields worn when body substances are likely to splash skin or mucous membrane

• Gowns and/or plastic aprons worn when body substances are likely to soil clothing or skin

• Gowns worn for holding infant to the uniform

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Cohorting

Cohorting infants with the same infection helps prevent spread of infections in the nursery

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Additional Precautions

• May be indicated for infants colonised or infected with epidemiologically significant microorganisms

• Suspected or confirmed infections should be handled according to guidelines developed by the Infection Control Team

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Single Rooms

• Priority given to mothers who soil articles in the environment with body substances and those colonised or infected with epidemiologically significant microorganisms

• Infants and/or mothers with diagnosed or suspected infections transmitted by the airborne route must be placed in a single room with negative pressure and the door closed

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Cleaning

• For labour and delivery suites, post delivery, remove soiled linens using gloved hands

• The delivery table/bed and the immediate patient environment should be cleaned after each use

• Use non-toxic disinfectants for cleaning neonatal equipment and incubators

• Avoid phenolic disinfectants

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General Infection prevention and control - 1• Parent/infant contact encouraged

• Except for the occasional case when there is a risk of transmitting infection

• Labouring mothers may shower or bath

• Post partum, instruct patient on daily perineal care after toileting

• Reviewing good hygienic policies with parents is vital to protect both mother and infant from acquiring or spreading infections

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General Infection prevention and control - 2• Prenatal assessment – to identify risk factors for

maternal/ newborn infection and allow prevention strategies

• Screen women for Group B streptococcus at 35-37 weeks gestation

• Screen for human immunodeficiency virus and Hepatitis B • HIV positive mothers should refrain from breastfeeding unless

alternatives are not available.

• Antepartum• Screen mothers upon admission for symptoms of infection

such as new onset of fever and other respiratory symptoms• New onset of cough, rash, or diarrhoea

• If the patient responds “yes” to the any of these conditions, initiate the appropriate additional precautions and spatial separation from other patients (> 2 metres)

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General Infection prevention and control - 3• Breast milk is protective as it provides specific

IgA antibody and helps establish normal flora in the neonate

• Provide post-partum hygiene for the mother and infant immunisations as required

• For facilities with little room and overcrowding, consider kangaroo mother care

• This includes skin to skin positioning of the baby on the mother’s chest

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Maternal/Child Infectious Diseases and IPC ManagementInfection/

Organism

Maternal

Precautions

Newborn

Precautions

Mother/Infant

Contact

Breast Feeding

AIDS Standard

Precautions

Standard

Precautions

Permitted No

Amnionitis Standard

Precautions

Standard

Precautions

Permitted Permitted

Antibiotic Resistant Organisms -Mother

VRE/MRSA:

Contact

Precautions

Standard

Precautions

Permitted Permitted

Antibiotic Resistant

Organisms - Infant

Mother uses

Standard

Precautions

VRE/MRSA:

Contact

Precautions

Permitted Permitted

Candida -

Mother

Standard

Precautions

Standard

Precautions

Permitted Permitted

Candida - Infant Standard

Precautions

Standard

Precautions

Permitted Permitted

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Adapted from Sunnybrook Health Sciences Centre, Toronto, On. 2010

23


Organism

Maternal

Precautions

Newborn

Precautions

Mother/Infant

Contact

Breast Feeding

Chickenpox

Mother ill – healthy

term infant

Airborne

precautions

Infant room in

with mother

Permitted Permitted

Chickenpox

Mother ill – Infant

in NICU

Airborne

precautions

Mother may not

visit the NICU

Standard

Precautions until

day 10. As of day

10 to and including

day 28 start

Airborne

Precautions

Not Permitted Permitted (as

expressed breast

milk)

Infant in NICU –

chickenpox or

contact

Only parents &

visitors who are

immune may

visit.

Airborne

precautions

Permitted if

woman is immune.

Permitted

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Organism

Maternal

Precautions

Newborn

Precautions

Mother/Infant

Contact

Breast Feeding

Chlamydia

Mother

Standard

Precautions

Standard

Precautions

Permitted Permitted

Chlamydia -

Newborn

Conjunctivitis

and/or pneumonia

Standard

Precautions

Standard

Precautions

Permitted Permitted

Conjunctivitis -

Bacterial

Standard

Precautions

Standard

Precautions

Permitted Permitted

Conjunctivitis -

Adenovirus Mother

Contact

Precautions.

No sharing of

towels, face

cloths, pillows,

linens

Standard

Precautions

Healthy Term

Infant: Room in

Extreme care with

hand hygiene

No sharing of

towels, linens

Permitted

Infant in NICU:

Mother NOT to go

to NICU

Permitted as

expressed breast

milk.

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Organism

Maternal

Precautions

Newborn

Precautions

Mother/Infant

Contact

Breast Feeding

Conjunctivitis

Adenovirus Infant

Standard

Precautions

Contact

Precautions.

No sharing of

patient care items.

As above As above

Cytomegalovirus

Mother

Standard

Precautions

Standard

Precautions

Permitted Permitted

Cytomegalovirus -

Infant

Standard

Precautions

Standard

Precautions

Permitted Permitted

Diarrhoea

Mother

Bacterial

(suspected or

confirmed)

Standard

Precautions

Single room with

toilet

Standard

Precautions

Healthy Term

Infant: Permitted

with Standard

Precautions.

Infant in NICU: Not

permitted until

asymptomatic for

48 hours.

Healthy Term

Infant: Permitted

Infant in NICU:

Permitted as

expressed breast

milk.

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Organism

Maternal

Precautions

Newborn

Precautions

Mother/Infant

Contact

Breast Feeding

Diarrhoea

Mother

Antibiotic

associated/C.

difficile

Contact

precautions

Single room with

toilet

Standard

Precautions

Permitted Permitted

Diarrhoea

Mother

Viral (e.g.,

norovirus)

Contact

precautions

Single room with

toilet

Contact

precautions

Single room with

toilet

Healthy Term

Infant: Permitted

with Standard

Precautions

Infant in NICU:

Woman is not

permitted in the

NICU until

asymptomatic for

48 hours

Healthy Term

Infant: Permitted

Infant in NICU:

Permitted as

expressed breast

milk.

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Organism

Maternal

Precautions

Newborn

Precautions

Mother/Infant

Contact

Breast Feeding

Diarrhoea

Infant

Bacterial

(suspected or

confirmed

Standard

Precautions

Contact

precautions

Permitted Permitted

Diarrhoea

Infant

Viral (e.g.

norovirus)

Standard

Precautions

Contact

precautions

Permitted Permitted

Endometritis Standard

Precautions

Standard

Precautions

Permitted Permitted

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Organism

Maternal

Precautions

Newborn

Precautions

Mother/Infant

Contact

Breast Feeding

Enterovirus

Mother

Contact

precautions

Single room

Contact

precautions Single

room

Healthy Term

Infant: Permitted

with Standard

Precautions.

Infant in NICU:

Woman is not

permitted in the

NICU until

asymptomatic.

Healthy Term

Infant: Permitted

Infant in NICU:

Permitted as

expressed breast

milk.

Enterovirus

Infant

Standard

Precautions

Contact

precautions

Ensure immediate

disposal of diapers

into leak proof bag

Permitted Permitted

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Organism

Maternal

Precautions

Newborn

Precautions

Mother/Infant

Contact

Breast Feeding

Gonococcal

Infections

Mother-Untreated

or <24 hours of

treatment

Standard

Precautions

Standard

Precautions

Permitted Permitted

Gonococcal

Infections - Infant

Conjunctivitis,

scalp abscess,

sepsis

Standard

Precautions

Standard

Precautions

Permitted Permitted

Hepatitis – Mother,

Type A

Standard

Precautions

Standard

Precautions

After prophylaxis

of infant

After prophylaxis

of infant

Hepatitis – Mother,

Type B (HbsAg+)

Standard

Precautions

Standard

Precautions

Permitted Permitted

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Organism

Maternal

Precautions

Newborn

Precautions

Mother/Infant

Contact

Breast Feeding

Hepatitis –Mother,

Type C

Standard

Precautions

Standard

Precautions

Permitted Permitted – see

Comments

Herpes simplex –

Mother, Genital –

delivered by

Caesarean section

Standard

Precautions

See Infant –

Asymptomatic

Permitted Permitted

Herpes simplex –

Mother, Genital –

vaginal delivery

Standard

Precautions

See Infant –

Asymptomatic

Permitted Permitted

Herpes simplex –

Mother, Oral or

mucocutaneous

(i.e., cold sore)

Standard

Precautions

See Infant -

Asymptomatic

Permitted.

Total rooming-in

preferred.

Permitted if there

are no herpetic

lesions on the

breast.

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Organism

Maternal

Precautions

Newborn

Precautions

Mother/Infant

Contact

Breast Feeding

Herpes simplex –

Mother , Whitlow

Standard

Precautions

See Infant –

Asymptomatic

Direct/hands-on

contact is NOT

permitted.

May pump and

discard milk until

lesions are gone or

may nurse if the

woman does not

touch her infant

(i.e. someone else

holds and

positions infant).

Herpes simplex –

Infant ,

Asymptomatic

Standard

Precautions

Contact

precautions. For

duration of

incubation period

(up to 4 weeks)

Permitted Permitted

Herpes simplex -

Infant,

Symptomatic

Standard

Precautions

Contact

precautions

Permitted Permitted

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Organism

Maternal

Precautions

Newborn

Precautions

Mother/Infant

Contact

Breast

Feeding

Herpes

zoster(shingles) -

Mother – localized

Standard

Precautions in

single room.

Only immune

staff may care for

patient.

Standard Precautions Permitted. Total

rooming-in

preferred. Mother

may not go to

nursery until

lesions are

crusted.

Permitted if

lesions are not

on breast.

Herpes

zoster(shingles)

Mother –

disseminated

Airborne

precautions

Immune staff only

Term Infant Rooming-

in: Standard

Precautions

Infant in NICU:Airborne precautions from day 10 from 1st

exposure to day 21 of last exposure (or day 28 if infant has been given VarIG).

Permitted. Total

rooming-in

preferred. Mother

may not go to

nursery until

lesions are

crusted.

Infant in NICU:

Woman may NOT

go to the NICU

until lesions are

crusted.

Permitted if

lesions are not

on breast.

Infant in NICU:Provide expressed milk.

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Organism

Maternal

Precautions

Newborn

Precautions

Mother/Infant

Contact

Breast Feeding

Influenza

Mother

Droplet &Contact

Precautions

Single room

preferred

Standard

Precautions

Healthy Term

Infant: Permitted.

Woman must wear

a surgical mask

when within 2

metres of infant.

Infant in NICU:

Woman is not

permitted to go to

NICU.

Healthy Term

Infant: Permitted

Infant in NICU:

Permitted as

expressed breast

milk.

Influenza - Infant Standard

Precautions

Droplet &Contact

Precautions

Permitted Permitted

Listeria

Mother

Standard

Precautions

Standard

Precautions

Permitted Permitted

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Organism

Maternal

Precautions

Newborn

Precautions

Mother/In

fant

Contact

Breast Feeding

Listeria

Infant

Standard Precautions Standard Precautions Permitted Permitted

Measles (Rubeola)

Mother ill – Term

healthy infant

Airborne Precautions Immune staff only

Only immune family

and visitors

permitted

Standard Precautions Room in

with woman

Permitted if

rooming in with

woman. May

provide expressed

breast milk if not

rooming in.

Measles (Rubeola)

Mother ill – infant

in NICU

Airborne Precautions

Immune staff only

Only immune

family and visitors

permitted

From 8 days from 1st

exposure to 12 days

from last exposure

Airborne Precautions

Immune staff only

Only immune family

and visitors

permitted

Woman not

permitted in

NICU until 4

days after

the

appearance

of the rash.

Permitted as

expressed breast

milk only until

woman no longer

infectious

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Organism

Maternal

Precautions

Newborn

Precautions

Mother/Infant

Contact

Breast Feeding

Measles (Rubeola)

Infant ill or

exposed

(i.e. exposed in

NICU)

Standard

Precautions

Airborne

Precautions

Immune staff

only

Only immune

family and

visitors

permitted

Woman immune –

permitted to see

infant

Woman

susceptible –

woman not

permitted to see

infant

Permitted

Woman

susceptible –

Permitted as

expressed breast

milk only until

infant no longer

infectious

Meningitis

Neissera

meningitidis/

Haemophilus

influenzae

Droplet

precautions until

24 hrs. after

appropriate

antimicrobial

therapy

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Organism

Maternal

Precautions

Newborn

Precautions

Mother/Inf

ant Contact

Breast Feeding

Mumps

Mother

Droplet/Contact

precaution Immune Staff

only

Only immune

family and

visitors permitted

Standard Precautions Term Infant:

Permitted

Term Infant:

Permitted

Mumps

Infant in NICU

Exposed or ill

Standard

Precautions

Droplet/Contact

precautions starting

from 10 days from

first exposure to 26

days from last

exposure. Single room

Immune Staff only

Only immune family

and visitors

permitted

Woman

immune –

permitted to

see infant

Woman

susceptible –

woman not

permitted to

see infant

Woman immune –

Permitted

Woman

susceptible –

Permitted as

expressed breast

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Organism

Maternal

Precautions

Newborn

Precautions

Mother/Infant

Contact

Breast Feeding

Pediculosis

Head Lice

Contact

Precautions

Precautions

remain in place

until after woman

has been

appropriately

treated.

Standard

Precautions

Healthy Term

Infant:

Permitted

Infant in NICU: Permitted once woman has been appropriately treated

Healthy Term

Infant: Permitted

Infant in NICU:

Permitted as

expressed breast

milk until woman

has been

appropriately

treated.

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Maternal/Child Infectious Diseases and IPC Management

Infection/

Organism

Maternal

Precautions

Newborn

Precautions

Mother/Infant Contact Breast

Feeding

Pertussis

Mother

Droplet

Precautions

Single room

Precautions

remain in place

until 5 days of

appropriate

antibiotic

treatment has

been completed.

Standard Precautions Healthy Term Infant:

Permitted. Reinforce hand

hygiene and wear a

surgical mask when within

2 metres of infant.

Infant in NICU: Not

permitted in NICU until 5

days of appropriate

antibiotic treatment has

been completed.

Healthy Term

Infant:

Permitted

Infant in NICU:

Permitted as

expressed

breast milk.

Pertussis

Infant

Standard

Precautions

Contact Precautions

Consider cohorting

Precautions remain

in place until 5 days

of appropriate

antibiotic treatment

has been completed.

Permitted Permitted

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Organism

Maternal

Precautions

Newborn

Precautions

Mother/Infant

Contact

Breast Feeding

Respiratory Virus

Infections

Mother ill

Droplet/Contact

Precautions

Single room

Standard

Precautions

Healthy Term

Infant: Permitted.

Reinforce hand

hygiene and wear

a surgical mask

when within 2

metres of infant

Infant in NICU: Not

permitted in NICU.

Healthy Term

Infant: Infant

rooming-in:

Permitted

Infant in NICU:

Permitted as

expressed breast

milk.

Respiratory Virus

Infections -

Infant ill

Standard

Precautions

Droplet /Contact

Precautions

Permitted Permitted

Infant in NICU –

chickenpox or

contact

Only parents &

visitors who are

immune may

visit.

Airborne

precautions

Permitted if

woman is immune.

Permitted

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Organism

Maternal

Precautions

Newborn

Precautions

Mother/Infant

Contact

Breast Feeding

Rubella

Mother

Droplet

precautions

Immune staff only

Droplet

precautions

Immune staff only

Healthy Term

Infant: Permitted

Infant in NICU:Woman cannot go into the NICU until 7 days after the onset of the rash.

Healthy Term

Infant: Permitted

Infant in NICU:Expressed breast milk as the woman cannot go into the NICU until 7 days after the onset of the rash.

Rubella

Infant (Congenital)

Standard

Precautions

Droplet

Precautions

Permitted Permitted

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Organism

Maternal

Precautions

Newborn

Precautions

Mother/Infant

Contact

Breast Feeding

Scabies Contact

Precautions

Precautions

remain in place

until after woman

has been

appropriately

treated.

Standard

Precautions

Healthy Term

Infant:

Permitted once

woman has been

appropriately

treated.

Infant in NICU:Permitted once woman has been appropriately treated.

Healthy Term

Infant:

Permitted once

woman has been

appropriately

treated or may

provide expressed

breast milk.

Infant in NICU:Permitted once woman has been appropriately treated or may provide expressed breast milk.

Staphylococcus

aureus - Mother

Mastitis

Standard

Precautions

Standard

Precautions

Permitted Permitted (see

Comments)

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Organism

Maternal

Precautions

Newborn

Precautions

Mother/Infant

Contact

Breast Feeding

Staphylococcus

aureus - Mother,

Breast Abscess

Standard

Precautions

Standard

Precautions

Permitted Healthy Term

Infant:

Permitted

Infant in NICU:

Permitted on the

unaffected breast

Staphylococcus

aureus – Mother,

Minor Wound

Infection

(contained) or Toxic

Shock Syndrome

Standard

Precautions

Standard

Precautions

Permitted if

draining lesion is

adequately

contained

Permitted

Staphylococcus

aureus - Mother,

Major Wound (not

contained)

Contact

Precautions

Standard

Precautions

Permitted if

draining can be

adequately

contained

Permitted

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Organism

Maternal

Precautions

Newborn

Precautions

Mother/Infant

Contact

Breast Feeding

Staphylococcus

aureus

Infant pneumonia

Standard

Precautions

Standard

Precautions

Permitted Permitted

Staphylococcus

aureus

Infant skin lesions

(localized or

scalded skin)

Standard

Precautions

Standard

Precautions

Including gloves

and gowns for

contact with

infant.

Permitted Permitted

Staphylococcus

epidermidis and

other coagulase

negative

staphylococcal

infections

Standard

Precautions

Standard

Precautions

Permitted Permitted

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Organism

Maternal

Precautions

Newborn

Precautions

Mother/Infant

Contact

Breast Feeding

Streptococcal

Disease Group A -

Mother, Minor

Wound Infection

(contained)

Single room

until 24 hours

after effective

treatment.

Standard

Precautions

Permitted Permitted

Streptococcal

Disease Group A -

Mother, Major

wound infection or

endometritis

Single room

until 24 hours

after effective

treatment.

Standard

Precautions

Permitted Permitted

Streptococcal

Disease

Group A -

Mother, Invasive

Disease

Single room

until 24 hours

after effective

treatment.

Standard

Precautions

Permitted after

24 hours of

effective

treatment.

Permitted after 24

hours of effective

treatment.

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Organism

Maternal

Precautions

Newborn

Precautions

Mother/Infa

nt Contact

Breast Feeding

Streptococcal

Disease

Group A -

Mother,

Pharyngitis (strep

throat)

Droplet Precautions.

Single room .

Precautions remain in

place until 24 hours

after effective

treatment

Standard

Precautions

Permitted after

24 hours of

effective

treatment

Permitted after 24

hours of effective

treatment.

Streptococcal

Disease

Group A (GAS) -

Infant

Standard Precautions Contact

Precautions

Precautions

remain in place

until 24 hrs. after

effective

treatment.

Streptococcal

Disease

Group A (GAS)

Infant

Standard

Precautions

Streptococcal

Disease

Group B (GBS) -

Mother,

Colonization

Standard Precautions Standard

Precautions

Permitted Permitted

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Organism

Maternal

Precautions

Newborn

Precautions

Mother/Infant

Contact

Breast Feeding

Streptococcal

Disease

Group B (GBS) –

Mother,

Endometritis

Standard

Precautions

Standard

Precautions

Permitted Permitted

Streptococcal

Disease

Group B (GBS) -

Infant

Colonization

Standard

Precautions

Standard

Precautions

Permitted Permitted

Streptococcal

Disease

Group B (GBS) -

Infant Sepsis or

Meningitis

Standard

Precautions

Standard

Precautions

Permitted Permitted

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Organism

Maternal

Precautions

Newborn

Precautions

Mother/Infant

Contact

Breast Feeding

Syphilis -

Mother,

Mucocutaneous

Contact

Precautions

Until 24 hours

effective

treatment

Standard

Precautions

Permitted after 24

hours effective

treatment.

Permitted after 24

hours effective

treatment.

Syphilis -

Infant,

Congenital

Standard

Precautions

Contact

Precautions

Until 24 hours

effective

treatment

Permitted Permitted

Toxoplasmosis

Mother

Standard

Precautions

Standard

Precautions

Permitted Permitted

Toxoplasmosis

Infant

Standard

Precautions

Standard

Precautions

Permitted Permitted

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Organism

Maternal

Precautions

Newborn

Precautions

Mother/Infant

Contact

Breast Feeding

Tuberculosis -

Mother,

Positive Skin test –

asymptomatic

Standard

Precautions

Standard

Precautions

Permitted Permitted

Tuberculosis -

Mother,

Pulmonary or

laryngeal on

effective treatment

Standard

Precautions

Standard

Precautions

Permitted Permitted

Tuberculosis -

Mother,

Pulmonary or

laryngeal – newly

diagnosed, on

inadequate

treatment or

noncompliant

Airborne

Precautions

Standard

Precautions

Not permitted

until woman is no

longer infectious

Mother may

provide expressed

breast milk.

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Organism

Maternal

Precautions

Newborn

Precautions

Mother/Infant

Contact

Breast Feeding

Tuberculosis

Mother

Extrapulmonary

Standard

Precautions

Standard

Precautions

Permitted Permitted unless

the

extrapulmonary TB

is causing a breast

abscess. Not

permitted until TB

abscess is treated.

Urinary Tract

Infection

Standard

Precautions

Standard

Precautions

Permitted Permitted

West Nile Virus Standard

Precautions

Standard

Precautions

Permitted Permitted

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Organism

Maternal

Precautions

Newborn

Precautions

Mother/Infant

Contact

Breast Feeding

Wound Infections -

Mother,

Minor or Limited

Standard

Precautions

Standard

Precautions

Permitted Permitted

Wound Infections -

Mother,

Major

Standard

Precautions

Standard

Precautions

Permitted Permitted

Wound Infections -

Infant

Standard

Precautions

Standard

Precautions

Permitted Permitted

Yeast Standard

Precautions

Standard

Precautions

Permitted Permitted

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References - 1• Committee on Infectious Diseases. (2012). The Red Book

29th Edition. Elk Grove Village, Illinois: American Academy of Pediatrics.

• Guidelines for the Prevention of Invasive Group A Streptococcal Disease, CCDR 2006; V32S2. http://www.phac-aspc.gc.ca/publicat/ccdr-rmtc/06pdf/32s2_e.pdf

• World Health Organization (WHO): Practical Guidelines for Infection Control in health Care settings, 2003. http://whqlibdoc.who.int/wpro/2003/a82694.pdf

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http://www.phac-aspc.gc.ca/publicat/ccdr-rmtc/06pdf/32s2_e.pdf





http://whqlibdoc.who.int/wpro/2003/a82694.pdf

http://whqlibdoc.who.int/wpro/2003/a82694.pdf

References - 2• World Health Organization, Geneva, 2010. Packages of

Interventions for Family Planning, Safe Abortion Care, Maternal, Newborn and Child Health.http://whqlibdoc.who.int/hq/2010/WHO_FCH_10.06_eng.pdf

• APIC. (2009). In APIC Text Infection Control and Epidemiology, 3rd Edition (Chapters 37, 38, 39). Washington: Association of Professionals for Infection Prevention and Control and Epidemiology

• World Health Organization (WHO): Recommendations for Routine Immunization 2010. http://www.who.int/immunization/policy/immunization_tables/en/index.html

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http://whqlibdoc.who.int/hq/2010/WHO_FCH_10.06_eng.pdf

http://whqlibdoc.who.int/hq/2010/WHO_FCH_10.06_eng.pdf

http://www.who.int/immunization/policy/immunization_tables/en/index.html

http://www.who.int/immunization/policy/immunization_tables/en/index.html

Quiz1. There are specific precautions required when mothers or

infants have communicable diseases. The issues centre around breast feeding and needed precautions. T/F?

2. Maternal infection risks area) Prolonged rupture of membranes (>24 hours)

b) Diabetes mellitus

c) Invasive tests and procedures

d) All of the above

3. Infection prevention strategies specific to maternal child health include all except:

a) Single rooms

b) Cohorting

c) Type of carpet in patient rooms

d) Screening for streptococcus

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International Federation of Infection Control• IFIC’s mission is to facilitate international networking in

order to improve the prevention and control of healthcare associated infections worldwide. It is an umbrella organisation of societies and associations of healthcare professionals in infection control and related fields across the globe .

• The goal of IFIC is to minimise the risk of infection within healthcare settings through development of a network of infection control organisations for communication, consensus building, education and sharing expertise.

• For more information go to http://theific.org/

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http://theific.org/

http://theific.org/

maternal child health - grande international hospital

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