2016 - 2017
Outlines
• At the completion of this lecture the student will be able to identify the
concept and related terms of:
• Infection- Infection control- Infectious disease - Communicable disease
• Occupational health strategies
• Healthcare-associated infection
• Healthcare-associated disease transmission
• Healthcare workers
• Nosocomial infection - Asymptomatic infection
• Colonization- Fomite - Vehicle
• Definition: infection defined as: The invasion and
multiplication of microorganisms such as bacteria,
viruses, and parasites that are not normally present
within the body.
• N.B: An infection may cause no symptoms and be
subclinical, or it may cause symptoms and be clinically
apparent.
• N.B: Infection may be local or generalized and spread
throughout the body.
Definition: Infection control defined as is practices help to
protect clients and healthcare providers from disease by
reducing and /or eliminating sources of infection.
• Defined as is Measures that aim to ensure the
protection of those who might be vulnerable to
acquiring an infection both in hospital due to health
problems and in general community. The basic
principle of infection prevention and control is
hygiene.
1. Infectious disease: any infection caused by
microbes or parasites.
2. Communicable disease: infection transmitted
from persons or animals to other persons.
 Patient may acquire infection before admission to the hospital
= Community acquired infection.
 Patient may get infected inside the hospital = Nosocomial
infection.
 It includes infections
infections that appear more than 48 hours after admission,
those acquired in the hospital but appear after discharge
also occupational infections among staff.
Absence of symptoms
or signs of illness in the infected person.
• Colonization: Proliferation of microorganisms
within body sites without detectable host immune
response, cellular damage, or clinical expression (i.e.
without symptoms or signs of disease). The host may
become a source of potential transmission.
• Fomite: Nonliving object that transmits infectious
agents from a reservoir to a host.
• Fomites: such as food, water or blood are called
vehicles.
• Examples: include tissues, doorknobs, telephones,
bed linens, toilet seats, and clothing. Any healthcare
equipment, supplies, or surfaces that have become
contaminated with pathogens can become a fomite.
• Vehicle: Objects such as food, water, biological products
(e.g. blood) and that may indirectly transmit an infectious
agent from a reservoir to a host.
• All fomites are vehicles, but not all vehicles are fomites.
• Outbreaks of disease are linked to common vehicles, such
as bacteremia resulting from use of intravenous fluids
contaminated with a gram-negative organism, or
gastroenteritis resulting from food contaminated with E.
coli.
 Any person who has contact with patients, body fluids, or
supplies used for patient care as part of their job.
 This includes physicians, nurses, occupational therapists,
physical
therapists,
as
well
as
administrative,
environmental hygiene, and laboratory staff in medical
facilities.
 All healthcare workers should be trained in basic infection
control regardless of whether they deliver direct care to
patients.
 The ways in which a pathogen is spread from an infected
person to another person.
 Common modes of transmission include:
1. Carrying: pathogens on unwashed hands
2. Contact: with surfaces or medical instruments that are not
cleaned between patients.
3. Droplets: released into the environment when an infected
person coughs.
4. Airborne: Most agents have multiple modes of transmission.
Introduction
• Healthcare-associated infections (HAIs) are
among the most common adverse events in
hospitals, and the morbidity and mortality
associated with them are significant.
• The Centers for Disease Control and Prevention (CDC)
estimate that 1 out of every 20 hospitalized patients
develop a healthcare-associated infection each year,
corresponding to almost 2 million infections and nearly
100,000 deaths in U.S. hospitals alone ( Yokoe, 2008/
CDC, 2011).
 The total burden of HAIs is likely to be even higher, since the
CDC estimates don't include nursing homes, home health care,
rehabilitation centers, dialysis centers, outpatient acute care.
 Patients in nursing homes and in home care are at risk for
developing HAIs, particularly if they have invasive medical
devices such as urinary catheters or central venous catheters in
place.
 In the United States, 1.6 to 3.6 million infections occur each year in longterm care facilities—almost as many HAIs as in acute care hospitals
(SHEA/APIC, 2008).
Site of Infection Total Cases Percent of Hospital HAIs
Urinary tract
561,667
32
Bloodstream
248,678
14
Pneumonia
250,202
15
Surgical site
290,485
22
Other sites
386,090
17
1,737,125
100
Total
• Refers to A set of activities intended to
assess, prevent, and control infections and
communicable diseases in healthcare
workers.
• About 3% to 15% of nursing home residents
acquire infection, and infection accounts for up
to 30% of transfers of nursing home residents
to hospitals.
• Healthcare-associated infections not only cause suffering
and death, but the medical costs for treating them,
prevention of HAIs has become a national healthcare
priority.
• Prevention of HAIs is the responsibility of all healthcare
personnel. Many states and most medical professional
organizations have defined standards of professional
behavior and responsibility as they pertain to infection
control.
• Healthcare workers—from physicians to dental hygienists—
may be sanctioned, including loss of license, for not
following effective infection control practices.
Four Ways to Prevent HAI
1. Maintain cleanliness of the hospital.
2. Personal attention to hand washing before and
after every contact with a patient or object.
3. Use personal protective equipment whenever
indicated.
4. Use and dispose of sharps safely.
• In 2001, the Occupational Safety and Health Organization (OSHA), the
federal organization regulating workplace safety, issued the Blood borne
Pathogens Standard aimed at preventing transmission of HIV and
Hepatitis B and C viruses in the workplace.
• The scientific basis for such infection control guidelines and standards
are derived from the work of experts at organizations such as the Centers
for Disease Control and Prevention (CDC), the Association for the
Prevention and Infection Control (APIC), and the Society for Healthcare
Epidemiology of America (SHEA).
Purposes of IPC in health care
 To prevent the occurrence of HAI in patients, health-care workers, visitors
and other.
Persons associated with health-care facilities. (Infection Program Control)
These infections may be:
− endemic, associated with the use of devices or procedures during health care;
− epidemic, originating within the population of the health-care facility;
􀂃 To prepare health-care facilities for the early detection and management of
epidemics and to organize a prompt and effective response;
􀂃 To contribute to a coordinated response to control community-acquired
infectious diseases, endemic or epidemic.
􀂃 To contribute to preventing the emergence of antimicrobial resistance and/or
dissemination of resistant strains of microorganisms; and
􀂃 To minimize the environmental impact of these infections or their management.
Questions
1. Define ( infection, infection control)
2. List common modes of transmission?
3. Enumerate purposes of IPC in health care?
4. What are Four Ways to Prevent HAI?