TOPIC: Control of Hospital Acquired Infections المحاضر: أ.د. علي عبداللاه عبدالرحمن ( جامعة طيبه) SPEAKER: prof. Ali A. Abdulrahman (Prof. of microbiology & Immunology Taibah University)

1. ‫الحمد ل رب العالمين والصل ة والسل م‬
‫على أشرف المرسلين وخاتم النبيين‬
‫سيدنا محمد صلى ال عليه وسلم‬
‫المؤمن القوي خير وأحب إلي ال‬
‫من المؤمن الضعيف وفي كل خير‬

2. CONTROL OF
HOSPITAL ACQUIRED
INFECTIONS

4. Being alert
More than 2 million persons affected a year
A 10% of all hospitalized patients
(Fourth leading cause of death (44,000-98,000
Cost hospitals $17-$29 billion annually
Average number of extra hospital days – 4
Average additional charge – excess of $2,000
April, 2011

6. Abdominal Operation

7. Microbiologist
- leading role in prevention because
specimens from the patient of all
clinicians are processed in the laboratory
-In a better position to discover the
hospital - acquired infection and
investigate its extent and treatment
 (Infection Control Program(

10. Air infection (contamination(
handkerchief
clothing
dust hand clothing
floor

11. Tracking NI has become difficult
Shorter inpatient stays than
microbial incubation period
(e.g. S. aureus wound
infections(
Surveillance systems are
optional to hospitals
March, 2010

15. Medical procedure with NI

21. Renal dialysis

22. Pseudomonas infection in
a burn wound

23. Growth from
contaminated objects

24. Candida albicans colonizing a fibrin clot
In heart valves
Candida albicans

25. Biofilm colonization a
cardiac pacemaker
Staph aureus

26. Staph infected silicon catheter

27. Why now?
Increased use of antimicrobials
create resistant bacterial strains
Hospital personnel fail to follow
basic infection control. ICUs,
asepsis is done in a rush of crisis
care
Patients in hospitals are
increasingly immunocompromised
April, 2009

28. Bacterial Resistance
Increasing as epidemiological
& clinical problem to patients
Current antimicrobial agents
lose their usefulness in
prevention & treatment in
hospitals
Genetic: chromosomal,
plasmids - conjugation
Nongenetic: spontaneous

29. Antibiotics resistances to NI
Sensitive
Resistant
sensitive

31. % frequently isolated pathogens

32. % frequently isolated pathogens (Cont’)

35. Other precipitating factors
-Transplants
-Blood transfusions
-More people undergoing
invasive surgery
-Infrastructure repairs and
renovations as hospital
facilities age

37. Sources of
nosocomial infections
Hospital water supply – no guidelines
exist
Buildup of biofilm and corrosion of
distribution lines
Aging distribution systems and water
stagnation
Strains of pneumonia known to survive
in water tanks
1 oocyst of Cryptosporidium
parvum/1000 L of drinking water could
cause 6000 infections per year in a city
the size of New York

38. Sources of nosocomial
infections (Cont’)
Unclean hands or gloves
Equipment (endoscope,
respiratory equipment, tube feed
bags) contaminated by bacteria-
infested water or improper
sterilization
Contaminated environmental
surfaces (sinks, drains)
inadequately cleaned

40. NI control not limited to bacteria
Cutback in hospital expenses –
laxity in pest control
Number of mice increase noticed –
crackdown with poison and glue
boards
Mice decrease noticed –
emergence of large, slow-flying,
iridescent flies in the hospital
Soon after maggots discovered in
the nostrils of IC patients
March, 2011

41. NI control not limited
to bacteria (Cont’)
Extensive mice infestation of the
cafeteria and canteen. Had not been
cleaned for more than a year.
Numerous carcasses found. One
mouse carcass can provide
sustenance for 100 larvae to grow to
maturity.

43. Appropriate emphases on
surveillance activities and
vigorous control efforts
At least one fulltime infection-
control professional per 250 beds
An expert hospital epidemiologist
Feedback of surgical wound
infection rates to practicing
surgeons
March, 2009

44. Mouse traps preferred over glue
boards
Avoid open cavity surgery – more
emphases on microscopic
procedures
Improve design of invasive
devices, development of
noninvasive monitoring systems
Strict antibiotic control programs
Routine maintenance of water
supply
Wash smart, not hard
Clean, clean, clean

46. ‫عرض أمثلة لتطبيقات على التعليم المستمر بالخارج‬
‫1- على مستوى الجامعة‬
‫2- علي مستوي المدينة و المملكة‬
‫3- التعاون مع المستشفيات ومشروعات بحثية‬
‫4- التعاون مع المراكز الصحية ووزارة الصحة‬
‫5- مع عامة الناس‬

47. ‫عرض أمثلة لتطبيقات على التعليم المستمر بالخارج‬
‫1- على مستوى الجامعة‬
‫2- علي مستوي المدينة و المملكة‬
‫4- التعاون مع المراكز الصحية ووزارة الصحة‬
‫5- مع عامة الناس‬

48. ‫عرض أمثلة لتطبيقات على التعليم المستمر بالخارج‬
‫1- على مستوى الجامعة‬
‫2- علي مستوي المدينة و المملكة‬
‫3- التعاون مع المستشفيات ومشروعات بحثية‬
‫4- التعاون مع المراكز الصحية ووزارة الصحة‬
‫5- مع عامة الناس‬

49. ‫عرض أمثلة لتطبيقات على التعليم المستمر بالخارج‬
‫1- على مستوى الجامعة‬
‫2- علي مستوي المدينة و المملكة‬
‫4- التعاون مع المراكز الصحية ووزارة الصحة‬
‫5- مع عامة الناس‬

50. ‫علةقة متلمزمة الشريان التاج الحادة بالعدوي‬
Anti H. pylori ABs Anti CM V ABs
100
Antibody Value (%)
80
60
40
20
0
Cases Control

51. Hospital of New Utopia
Bioscanners that records people’s
health signature when walking
through the door.
First floor of hospitals devoted to
decontaminating visitors and
inbound patients.
ICU centers are built separate from
the rest of the hospital, and every
ICU bed is a self contained bubble.
Sterile water for everyone.
March, 2008

52. Inanmate sources &
vehicles of NI

53. Precautions against
accidental needle sticks

54. Blood precautions for HIV infection

55. Specimen collection box

56. Disinfectants & antiseptics
used in hospital

57. Recommended biosafety levels
Safety Practices & Safety Equipment Facilities
Level Techniques
1
2
3
4

58. Infection control policy
Air

59. Blood cultures

60. Control of hospital
infection
Infection control
committee.
Procedure for
infection control.
Surveillance system.

61. Video

62. Thank
you