1. HOSPITAL ACQUIRED
INFECTIONS.
Prepared By Dr. Anees A. AlSaadi
Medical Resident R1.
20.1.2011

3. INTRODUCTION :
 Definition :
 Are Group of infections.
 No evidence of incubation on admission.
 Caused by Variety of organisms.
 Could be acute OR chronic.

4. BURDEN :
 Nosocomial infections are widespread.
 They are important contributors to morbidity
and mortality.
 Cost either directly or indirectly.

5.  CDC :
BURDEN
 1.7 million infections.
 99,000 associated
deaths each year.3
 5% of all hospitalizations in
the US.
 WHO:
 8.7% of hospitalized
patients had (HAI).

6.  WHAT ARE THE MOST
COMMON INFECTIOUSE
AGENTS ….. ?

7. INFECTIOUS AGENT:
 ( MRSA).
 Tuberculosis.
 Invasive group A streptococcal infections .
 Influenza.
 Clostridium difficile diarrhea .
 Scabies .

8. RESERVOIR:
 Humans either the staff or the
patients and medical associated
procedures and environment are
the usual reservoirs in this case.

9. PORTAL OF EXIST: PORTAL OF ENTRY :
 It is variable . It could be through:
 Respiratory discharges e.g. influenza viruses.
 Stool e.g. Rota virus and adenoviruses.
 Skin e.g. Scabies .
 Genito urinary

10. MOOD OF TRANSMISSION :
 All means of transmission being involved
 Except :
 Soil contact
 Vertical.

11. Host susceptibility

12. HOST SUSCEPTIBILITY :
Age. Gender. Occupation.
• Neonates. • No • Intensive care
• elderly predominance. units.
patients • Emergency
department.
• Laboratory
medicine..

13. HOST SUSCEPTIBILITY :
General medical condition: Environmental factors:
• Chronic ill patients.
• Variety of medical
• Immunocompromised. procedures.
• Long term medical devices . • Invasive techniques
creating potential routes of
• Long term antibiotics infection.
• Bedridden state. • Drug-resistant bacteria.
• Low activities . • Crowded hospital
populations.
• Poor infection control
practices .

14. CLINICAL FEATURES :
 Pneumonia.
 Infectious diarrhea and
foodborne illness.
 Septicemia.
 UTI .
 Decubitus ulcers .
 Conjunctivitis.

15. DIAGNOSIS AND TREATMENT :
 Diagnosis is clinical scenario oriented .
 Cultures for blood, urine, stool and even sputum
samples.
 Viral serology should always be considered.
 Treatment is case oriented . But the initial must
be empirical and wide spectrum coverage.

16. PREVENTION :
 General Measures:
 Health education:
 Not only to the patient or visitors but medical staff
also.
 Educate the medical staff about (HAI) mood of transmission .
ect.

17.  Hand washing is very important issue .

18. PREVENTION
 Health promotion:
 Provide the facilities for hand washing and personal
hygiene.
 Ideal settings to prevent blood diseases transmission.
 Facilitate no crowding .

19. PREVENTION ENVIRONMENTAL
 Safe water supply .
 Prober disinfection.
 Sanitary disposal of waste .
 Food sanitation and food handlers control..

20. PREVENTION ENVIRONMENTAL
 Dust control .
 Control of respiratory droplets .
 Regular instrumental sterilization.
 Usage of disposal instruments.
 Blood and its products screening.

21. PREVENTION
 Administrative measures:
 Control infection committee :
 To formulate the policies for infectious cases admission.
 Coordinate all infection control facilities.
 Formulates a medical staff rule when being ill.
 Formulate rules for the visitors to the hospitals.

22. PREVENTION : SPECIFIC MEASURES:
 Vaccination :
 All staff should be vaccinated for the most
common organisms .
 Chemoprophylaxis :
 This is applicable in some situations like in case
of T.B contacts like nurses where INH must be
given .

23. CONTROL : (
HIV, Hepatitis,
 Cases :
Meningitis, T.
 Early case finding .
B ) are of A
level .
 Notification :
 Isolation : Many infections must be
isolated like (active open T.B, MRSA ….ect. )
 Disinfection : all patients secretions, fluids ect. Must
be ideally disinfected.
 Treatment.
 Release .

24. CONTROL : CASES :
 Rehabilitation : so important for both the
inpatient and even the medical staff whom become
infected by what ever organisms as (HAI)
psychological rehabilitation and reassuring is
essential as the medical rehabilitation.

25. CONTROL :CONTACTS :
 The general rule is applied depending on the case.
 Enlistment.
 Surveillance for early case finding and testing it by
prober laboratory investigation.
 Immunization or chemoprophylaxis if applicable.
 Treatment is applicable.

26. ENVIRONMENTAL HAZARDS CONTROL:
 Safe water supply .
 Prober disinfection.
 Sanitary disposal of waste .
 Food sanitation and food handlers control.

27. ENVIRONMENTAL HAZARDS CONTROL:
 Dust control .
 Control of respiratory droplets .
 Regular instrumental sterilization.
 Usage of disposal instruments.
 Blood and its products screening.
 Collaborating .

28. THANK YOU !