Infection Control
Connie Cavenaugh
UAMS’ Infection Control Practitioner
Standard Precautions
Standard precautions are to be used with all
patient contact. Treat all blood and body fluids
as infectious. Use gloves if touching nonintact skin, use gowns if soiling is likely, & use
a mask if the potential for splashing may
occur. Standard precautions are designed to
protect you and the patient.
Equipment used from patient to patient
(wheelchairs, stretchers, blood pressure
machines, etc) should be disinfected in
between patient use by using hospital
approved disinfectant wipes.
What are Isolation Precautions?
These precautions are determined by
the mode of transmission of the
suspected or known disease.
- Airborne Precautions
Tuberculosis, Measles, Chickenpox,
SARS
-Droplet Precautions
Meningitis, Influenza
-Contact Precautions
MRSA, VRE, C. difficile, RSV
Isolation
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Airborne Precautions
Tuberculosis
Chicken Pox*
Measles
SARS
*Requires both airborne and contact precautions
Tuberculosis
TB is spread through the air from one person to another.
The bacteria are put into the air when a person with
TB disease of the lungs or throat coughs or sneezes.
People nearby may breathe in these bacteria and
become infected. Symptoms of TB depend on where
in the body the TB bacteria are growing. TB bacteria
usually grow in the lungs. TB in the lungs may cause
* a bad cough that lasts longer than 2 weeks
* pain in the chest
* coughing up
blood or sputum
* weakness or fatigue
* weight loss
* no appetite
* chills
* fever
* sweating at
night
Suspect or known TB patients must be housed in a
negative pressure room. Staff dedicated to take care
of these patients must be fit tested for N95
respirators through OH&S
Isolation
 Droplet
Precautions
 Meningitis
 Influenza
Meningitis
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
Meningitis is an inflammation of the meninges, the
membranes that cover the brain and spinal cord. The
inflammation is usually caused by bacteria or viruses
(viral meningitis is also called aseptic meningitis).
Many of the bacteria or viruses that can cause meningitis
are fairly common and are more often associated with
other everyday illnesses. Sometimes, however, they
spread to the meninges from an infection in another part
of the body. The infection can start anywhere, including in
the skin, gastrointestinal tract, or urinary system, but the
most common source is the respiratory tract. From there
the microorganisms can enter the bloodstream, travel
through the body, and enter the central nervous system.
In some cases of bacterial meningitis, the bacteria spread
directly to the meninges from a severe nearby infection,
such as a serious ear infection (otitis media) or nasal
sinus infection (sinusitis). Bacteria may also enter the
central nervous system after severe head trauma or head
surgery.
Bacterial Meningitis
 Bacterial meningitis is less common than viral
meningitis but is usually much more serious and can
be life-threatening if not treated promptly. Many
different types of bacteria can cause meningitis:
Group B Streptococcus, Escherichia coli, and Listeria
monocytogenes are the most common causes of
meningitis in newborns. Streptococcus pneumoniae
(pneumococcus) and Neisseria meningitidis
(meningococcus) are more frequent in children older
than 2 months of age. Before the 1990s, Haemophilus
influenzae type b (Hib) was the leading cause of
meningitis in children in the United States. But the
widespread use of the Hib vaccine as a routine
childhood immunization has dramatically decreased
the frequency of meningitis caused by Hib.
Viral Meningitis
 Viral meningitis is relatively common and far
less serious than bacterial meningitis. It often
remains undiagnosed because its symptoms
are similar to those of the common flu. The
frequency of viral meningitis increases slightly
in the summer and fall months because
people are more often exposed to common
viral agents during those seasons. Most cases
of viral meningitis are associated with
enteroviruses - viruses that typically cause
stomach "flu."
Prophylaxis
 After a diagnosis of “meningitis”
has been made, it is very
common for healthcare workers
to want “prophylaxis” to prevent
transmission. It is very
important to understand that
the only prophylaxis given is for
meningococcal meningitis
(Neisseria meningitidis).
Isolation
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MRSA
VRE
C. difficile
RSV
MRSA
MRSA is Staphylococcus aureus that has
developed resistance to all the penicillin
drugs normally used to treat this type of
infection. Wearing gloves with all patient
contact, using gowns with significant
patient contact, and being vigilant about
hand hygiene & equipment disinfection
will protect you and your patients. MRSA
is most often spread via the hands of
healthcare workers.
 CA-MRSA (Community-associated) is becoming
more and more prevalent. These infections
most often present as skin and skin structure
infections mimicking “spider bites”. They are
NOT spider bites!
VRE
VRE is an Enterococcus that has
developed resistance to Vancomycin.
Enterococcus lives normally in the GI
tract and can also be a normal flora in
the groin and perineal area.
Enterococcus can live for weeks on
inanimate objects like bedrails, bedside
commodes, & tables. Strict Contact
Precautions are necessary to prevent
the spread of VRE. Gowns & Gloves
must be worn BEFORE entering the
patient room. Strict adherence to hand
hygiene is very important to prevent
transmission.
Clostridium difficile
C. diff is a spore-forming bacteria that can
produce toxins and cause severe diarrhea.
Spores can live in the environment for weeks
and C. diff is not killed easily by routine
disinfectants. C. diff infection is on the rise
and new novel strains have been detected over
the last several years. STRICT Contact
Precautions are necessary to prevent the
transmission. Gowns & Gloves must be worn
BEFORE entering the patient room.
Alcohol gel is not as effective against C diff as a
good handwash.
Multi-drug resistant organisms:
Acinetobacter baumanii (MDR-Ac),
Pseudomonas