A small effort to share useful information with regard to the rising threat to the healthcare facilities and how to prevent it.

1. NOSOCOMIAL INFECTIONS
( Hospital Acquired Infection/ Hospital
Associated Infection)
•
Presented by:-
• Dr. Bhamini Thukral

2. What is Nosocomial Infection??
•Any infection causing illness that was not present or in
its incubation period when the subject entered hospital
or received treatment in outpatient clinic.
•Infections are considered Nosocomial if they first
appear 48 hours or more after hospital admission or
within 30 days after discharge.
•“Nosocomial” comes from two Greek words- “nosus”
meaning “disease”+”komeion” meaning “to take care
of”----disease contracted by a patient while under
medical care.

3. WHO notes that the rate of nosocomial infection will
continue to rise as a result of four factors
• Crowded hospital conditions
• Increasing number of people with compromised
immune systems
• New micro-organisms
• Increasing bacterial resistance

4. Routes of Transmission
1. Contact
2. Airborne
3. Commom vehicle
4. Vector borne
NOTE:The same micro-organism may be transmitted by
more than one route

5. 1.Contact route of transmission
• May occur through 3 routes
Direct contact
Indirect contact
Droplet contact

6. Direct contact

7. Direct Contact
Physical transfer
 Between hospital personnel and patient
or
 Between patients

8. Indirect contact
• Personal contact of hospital personnel with
infected instruments, dressings,materials etc.
• Due to improper handling of used intruments
and equipments

9. Droplet contact
• Droplets generated by coughing,sneezing, or
respiratory tract procedures such as
bronchoscopy and suction.
• Considered as contact transmission as
droplets do not travel more than 3ft.

10. 2.Airborne route of transmission
• Tiny droplet nuclei that remain suspended in
air(<5 microns)
• Dust particles inhaled by susceptible host

11. 3.Common Vehicle route
• Transmitted indirectly by material
contaminated with the infectious agents.(e.g
contaminated food, water, blood products,
instruments and other items)

12. 4.Vector borne route of transmission
• Transmission through disease carrying
organisms such as insects , mosquitoes ,fleas
etc.

13. Factors promoting NCI in healthcare
settings

14. Implications of NCI
• Serious disabling conditions-detrimental effect
on quality of life
• Delayed wound healing
• Increased cost due to prolonged
hospitalization
• Morbidity and mortality
• Community risk

15. MRSA Superbug???
• According to the Centres for Disease Control and
Prevention:
MRSA, which stands for methicillin-resistant
Staphylococcus aureus, is a type of staph bacteria
that is resistant to several different types of
antibiotics.
• “SUPERBUG”-called so because it readily spreads
especially in crowded living conditions.

16. How you catch it?
• MRSA is spread through contact with
someone who already has the infection, using
a personal item that has come in contact with
someone with an infection or by touching a
contaminated surface.

17. Symptoms of MRSA
• MRSA infections are mainly characterized by
painful, irritating red bumps and rashes.
However, if the bacteria enter the
bloodstream, the infection can spread to and
damage vital organs. In extreme cases, MRSA
infections can be fatal.

18. Prevention of MSRA Superbug
• The best way to keep from getting an infection
is maintaining good hygiene
• Proper hand washing.
• The community as a whole can slow the
progression of MRSA by using antibiotics
responsibly and sparingly.

19. NDM-1 Superbug
• New Delhi metallo-beta-lactamase-1
• Widespread in India,Pakistan and has reached
Europe,Australia and Canada.
• A highly rare genetic mutation
• Highly impermeable to powerful antibiotics.

21. NCI prevention and control
1. Isolation precautions
• Airborne precautions(requires negative air pressure
room)
• Droplet precautions
• Contact isolation
2. Hand hygiene
3. General ward hygiene measures
4. Environmental or surface sanitation
5. Wearing gloves
6. Appropriate handling of soiled linen

22. 2. Hand hygiene
• Hand hygiene is the simplest and most
effective measure for preventing hospital
acquired infections.

23. Hand hygiene measures
1. Alcohol hand rub
2. Routine hand wash 10-15 seconds
3. Aseptic procedures 1 minute
4. Surgical wash 3-5 minutes

24. Alcohol hand rubs
• Requires less time
• Readily accessible
• All patient care areas
• Acts faster
• Less irritating
• Excellent bactericidal activity
• Sustained action

25. Routine hand wash

28. General ward hygiene measures
• No overcrowding
• Good ventilation
• Regular removal of dust
• Wound dressing early in day
• Disposable equipment

29. Successful Promotion 
• Education
• Routine observation & feedback
• Engineering controls
– Location of hand basins
– Possible, easy & convenient
– Alcohol-based hand rubs available
• Patient education

30. Successful Promotion 
• Reminders in the workplace
• Promote and facilitate skin care
• Avoid understaffing and excessive
workload