5. Health Care-Associated
Infection (HAI)
3
• Localized or systemic condition resulting from an adverse reaction to
the presence of an infectious agent(s) or its toxin(s)
• There must be no evidence that the infection was present or
incubating at the time of admission to the hospital
• For most bacterial infections, this means that the infection usually
become evident 48 hours (the typical incubation period) or more after
admission
6. Health Care-Associated
Infection (HAI)
4
Because the incubation period varies with
- the type of pathogen
- the patient’s underlying condition
Each infection must be assessed
individually for evidence that links to
the hospitalization
7. Health Care-Associated
Infection (HAI)
5
May be caused by infectious agents from
• Endogenous sources :- skin, nose, GI tract or
vagina that are normally inhabited by
microorganisms
•Exogenous sources :- patient care
personnel, visitors, patient care equipment,
medical devices or health care environment
26. Acinetobacter
• Aerobic gram-negative coccobacilli, non-spore forming
• > 25 species
•A. baumannii is the most common cause of
ventilator- associated pneumonia (VAP)
•Opportunistic pathogen
27. A. baumannii
Clinical manifestation of A. baumannii infection
1.Hospital-acquired pneumonia especially VAP
2.Community-acquired pneumonia :The source of infection
may be throat carriage, which occurs in 10% of community
residents with excessive alcohol consumption
3.Bloodstream infection & endocarditis
4.Skin/soft tissue infection
5.UTI
6.Meningitis
29
29. A. baumannii
Persistence in the hospital environment :
3 days to 5 months
1. Resistance to major antimicrobial drugs
2. Resistance to desiccation
3. Resistance to disinfectant
Three factors contributing to the persistence :
31
39. Enterococci
• Gram-positive cocci in chain
• Commensals of the GI tract of humans & animals
• Diseases :
• Consist of 16 species :- E. faecalis, E. faecium
- Urinary tract infection (UTI)
- Bacteremia, endocarditis
44
42. VRE Transmission
Health care
settings
Community
settings
Colonization of discharged patients
with VRE
Discharge
Colonization of individuals
Colonization of patient
Admission
Colonization & transmission among
food producing animals effects by
Avoparcin / Glycopeptide
Ingestion
Household transmission
Colonization or infection identified
due to selective antimicrobial
pressure and/or underlying illness
Health care transmission Worker hands
Environment
48
43. BACTERIA Duration of persistance (range)
Acinetobacter spp. 3 days to 5 months
Clostridium difficile (spores) 5 months
Escherichia coli 1.5 hours -16 months
Enterococcus spp.including VRE and VSE 5 days - 4 months
Klebsiella spp. 2 hours to >30 months
Mycobacterium tuberculosis 1 day - 4 months
Pseudomonas aeruginosa 6 hours -16 months;
on dry floor : 5 weeks
Staphylococcus aureus, including MRSA 7 days - 7 months
Persistence of nosocomial bacteria on dry inanimate surfaces
49
48. Generalized Transduction (3)
6 7
Genetic exchangeDonor bacterial DNA is
injected into recipient cell
Any piecies of the DNA of the donor cell can be transferred
3
54
54. GOOD LUCK
SAMIR EL ANSARY
ICU PROFESSOR
AIN SHAMS
CAIRO
elansarysamir@yahoo.com
Global Critical Care
https://www.facebook.com/groups/1451610115129555/#!/groups/145
1610115129555/
Wellcome in our new group ..... Dr.SAMIR EL ANSARY
