LECTURE 3 Hospital Infections NOSOCOMIAL ANY DISEASE OR

LECTURE #3 Hospital Infections (NOSOCOMIAL)

ANY DISEASE OR CONDITION THAT ORIGINATES OR OCCURS IN A HOSPITAL OR HOSPITAL-LIKE SETTING RESPONSIBLE FOR ABOUT 90, 000 DEATHS IN THE U. S. PER YEAR

SITES OF NOSOCOMIAL INFECTIONS (FROM MOST TO LEAST COMMON) 1. URINARY TRACT 2. SURGICAL WOUNDS 3. RESPIRATORY TRACT 4. SKIN (ESPECIALLY BURNS) 5. GASTROINTESTINAL TRACT 6. CENTRAL NERVOUS SYSTEM

NOSOCOMIAL INFECTIONS (cont) 1. HIGH PREVALENCE OF PATHOGENS THE HOSPITAL “HOUSES” MANY OPPORTUNISTIC MICROORGANISMS THAT TEND TO ACQUIRE ANTIBIOTIC RESISTANCE FACTORS THESE PATHOGENS ALSO TEND TO BECOME INCORPORATED INTO THE NORMAL FLORA OF HEALTHY OR NON-INFECTED PATIENTS, AND WORKERS

NOSOCOMIAL INFECTIONS (cont) 2. HIGH PREVALENCE OF COMPROMISED HOSTS PATIENTS TEND TO BE SUSCEPTIBLE TO INFECTION BECAUSE THEY DISPLAY BROKEN SKIN OR MUCOUS MEMBRANES (WOUNDS) MANY PATIENTS ARE IMMUNODEPRESSED – THEIR IMMUNE SYSTEMS ARE LESS ABLE TO FIGHT OFF INFECTIONS ONCE ACQUIRED

3. EFFICIENT MECHANISMS OF TRANSMISSION = CHAINS OF TRANSMISSION: AIRBORNE – MICROORGANISMS IN THE AIR MAY SPREAD IN AIR DUCTS OR VENTILATING SYSTEMS AND INHALED DIRECT PERSON-TO-PERSON CONTACT – BETWEEN AN INFECTED PATIENT, STAFF MEMBER, OR VISITOR AND NONINFECTED PATIENTS INDIRECT CONTACT – THROUGH EQUIPMENT, SUPPLIES, AND HOSPITAL PROCEDURES

NOSOCOMIAL INFECTIONS (cont) DROPLETS – SMALL PARTICLES OF MUCUS OR MICROBES THAT REMAIN SUSPENDED IN THE AIR FOLLOWING COUGHING, SNEEZING, OR TALKING VEHICLE – ANY SUBSTANCE OR OBJECT THAT CAN CARRY MICROORGANISMS FROM ONE HOST TO ANOTHER (CONTAMINATED FOOD, WATER, DRUGS, BLOOD, OR BODY FLUIDS)

UNIVERSAL PRECAUTIONS FOR HOSPITAL WORKERS: 1. PRACTICE ASEPTIC TECHNIQUES 2. WASH YOUR HANDS FREQUENTLY 3. WHEN POSSIBLE, USE SINGLE-USE ITEMS 4. AVOID DIRECT CONTACT WITH PATIENTS, FOMITES, AND ESPECIALLY, BODY FLUIDS 5. WEAR BARRIERS SUCH AS GLOVES WHEN CONTACT IS NECESSARY OR EXPECTED 6. AVOID PUNCTURING YOURSELF WITH ANYTHING AND MINIMIZE EXPOSURE TO SHARP INSTRUMENTS

ADDITIONAL PRECAUTIONS: 1. PATIENT ISOLATION – PUTTING A PATIENT WITH AN INFECTIOUS DISEASE IN A SINGLE ROOM 2. USE OF AIR FILTRATION SYSTEM 3. ADDITIONAL ROOM CLEANING 4. CAREFUL USE AND DISINFECTANT OF DEDICATED PATIENT EQUIPMENT