www.cf.edu
www.wdt.edu
Nosocomial Infections
 Infectious diseases that are acquired within hospitals
or other healthcare facilities
 Includes infections that appear within 14 days of
hospital discharge
 Iatrogenic infections – “physician-induced”
 Caused by healthcare personnel
www.normeditec.com
Who Are the Culprits?
 Which pathogens are usually involved in nosocomial
infections?
 Gram-positive Cocci
 Staphylococcus aureus
 Coagulase-negative staphylococci
 Enterococcus spp.
 Gram-negative Bacilli
 Escherichia coli
 Pseudomonas aeruginosa
 Enterobacter spp.
 Klebsiella spp.
Drug-Resistant Bacteria
 Often become evident due to frequent use of




antimicrobial agents
Emerge due to selective pressures
Those that are not affected by antimicrobial agents
survive and thrive while those that are die
Survival of the fittest microbes
Viruses (i.e. HIV), fungi (Candida spp.), protozoa
(malarial parasites)
www.who.int/entity/drugresistance/malaria
How do bacteria become resistant?
Most Common Types of
Nosocomial Infections
 Urinary tract infections (UTIs)
 Surgical wound infections
 Lower respiratory infections (i.e. pneumonia)
 Bloodstream infections (septicemia)
 Gastrointestinal diseases caused by Clostridium
difficile.
Clostridium difficile.
www.wellcome.ac.uk
www.waitakere.govt.nz
Medical Asepsis
 “clean technique”
 Involves procedures and practices that reduce the
number and transmission of pathogens
 Would this be an example of disinfection or
sterilization?
Surgical Asepsis
 “sterile technique”
 Procedures that aim to make and keep objects and
areas sterile.
 What might a surgical technician do to get ready for a
surgery?
 What might a surgical technician do to get a patient
ready for surgery?
Standard Precautions
 Defined by CDC
 Follow standard precautions for all patients
 Aim to reduce the transmission of bloodborne and
other pathogens in hospitals through bodily fluids
www.cdc.gov
Handwashing
 Most important and basic technique in preventing and
controlling infections and preventing the transmission
of pathogens
 Wash between patients
 Ignaz Philipp Semmelweis (1818-1865)
 “Father of Handwashing”
www.zol.be
www.generalanaesthesia.com
Gloves
 Worn when touching blood, body fluids, secretions,
excretions, and when touching mucous membranes or
nonintact skin
www.safecare-gloves.com
Masks, Eye Protection,
Face Shields, and Gowns
 Are often worn when procedures or activities may
result in splashes or sprays of blood, body fluids,
secretions, or excretions
www.newtonsafety.com
Additional Standard
Precautionary Measures
 Patient-Care Equipment
 Environmental Control
 Linens
 Occupational Health and Bloodborne Pathogens
 Patient Placement
Standard Precautions
www.uow.edu.au
Transmission-Based Precautions
 5 Main Routes of Transmission of Pathogens
 1. Contact (direct or indirect contact)
 2. Airborne
 3. Droplet
 4. Vehicular
 5. Vectors
Transmission-Based Precautions
 Airborne Precautions
 Droplet Precautions
 Contact Precautions
Spread of tuberculosis by droplet
nuclei. pathport.vbi.vt.edu
Infection spread by
droplets.
www.leighbrodie.com
Infection spread by
direct contact.
www.cse.unsw.edu.au
Types of Isolation
 Source Isolation
 Isolating patients with infectious diseases to prevent
spreading disease
 Protective Isolation
 Isolating patients who are immunosuppressed to avoid
disease
Infection Control Programs
 All healthcare facilities have infection control
programs that strive to prevent the presence and
spread of infectious diseases.
www.southeasttech.edu
Chemotherapy
 Use of any chemical (drug) to treat any disease or
condition
 Chemotherapeutic Agent – any drug used to treat
any condition or disease
Antimicrobial Agents
 Any chemotherapeutic agent used to treat infectious
diseases
 Inhibits or kills pathogen in vivo (in living organism)
 Antibacterial agents


Antibiotics
Semisynthetic antibiotics
 Antifungal agents
 Antiprotozoal agents
 Antiviral agents
Antibacterial Agents
 Sulfonamide Drugs
 Inhibit production of folic acid.
 Drug mimics another molecule that is used to produce folic
acid.
 Penicillin
 In most gram-positive bacteria, interferes with the synthesis
and cross-linking of peptidoglycan in cell wall.
 Narrow-spectrum Antibiotics
 Kills either gram-positive or gram-negative bacteria.
 Broad-spectrum Antibiotics
 Can kill both gram-negative and gram-positive bacteria.