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Hospital acquired infection
1. HOSPIAL ACQUIRED INFECTION
(DEPARTMENT OF COMMUNITY MEDICINE)
Moderated by- Dr. Dhiraj Srivastava
Presented by- Srihari Adhikari
Roll No.- 73
Batch- 2010
2.
3. Definition
• Hospital acquired infection / nosocomial
infection are infection acquired during
hospital care which are not present or
incubating at admission.
• Infection occurring more than 48 hours after
admission are usually considered nosocomial.
4. • Word Nosocomial
comes from the
greek word
nosokomeion
meaning hospital
(nosos= disease,
komeo= to take
care of)
5. Definition by CDC
• Infection that patients
acquire during the
course of receiving
treatment for other
conditions or that health
workers acquire while
performing their duties
within healthcare setting
6.
7. Surgical site infection
• Any purulent discharge
or abscess or spreading
cellulitis at the surgical
site during the month
after the operation.
8. Urinary infection
• Positive urine
culture (1 or 2
species) with at
least 1o
thousand
bacteria/ml
without clinical
symptoms.
9. Respiratory infection
Respiratory symptoms with at least 2 of
the following signs appearing during
hospitalization
• Cough
• Purulent sputum
• New infiltrate on chest
radiograph consistent
with infection.
15. Complication or
extension of
infection(s)
already present on
admission unless a
change in pathogen
or symptoms
strongly suggest
the acquisition of
new infection
16. Infection in an
infant that is
known or proven
to have been
acquire
transplacentally &
become evident
before 48 hour of
birth
23. Prospective study in burn unit of a
tertiary case referral centre in north
india
• Hospital wide study is Performed by Taneja N.,
Emmanuel R.,Chari P S, Sharma M. in 2004
• 71 patient developed 59 hospital acquired
infection.
• Infection density- 36.2 infection
per 1000 patient day
• Commonest- invasive wound
infection
24. U.T.I. study in JNMC Aligarh
• Performed by M. Akram, M.Shahid, A U Khan in
2007.
• 100 sample infected out of 920 tested urine
sample.
• Infection of
E. Coli- 61%
Klebsiella – 22%
27. 2) Routes of spread
a) Direct contact
b) Droplet infection
c) Air borne particle
d) Release of hospital dust into the air
e) Through various hospital procedure
32. e) Through various hospital procedure like
• catheterization
• Intravenous
procedure
• dressing
• infected cat gut
• sputum cups
• bed pans
• urinals etc.
33. 3) RECIPIENTS
a) Patient especially severely ill & under
corticosteroid therapy
b) Cross infection is greater in
• Intensive care unit
• Urological ward
• Geriatric ward
• Special baby care unit
38. WHO guideline for hand
hygiene in health care
• Washing hand with soap
& water
• Preferably use an alcohol
based hand rub for routine
hand antisepsis
• When alcohol based
hand rub is already used
do not used antimicrobial
soap concomitantly.
39. Perform hand hygiene
• Before & after having direct contact with patients
• Before handling an invasive device for patient
care regardless of whether or not gloves are used
• After contact with body fluid or excretion , mucus
membrane, non intact skin, or wound dressing.
• If moving from a contaminated body site to a
clean body site during patient care.
• After contact with inanimate objects (including
medical equipment) in the immediate vicinity of
the patient.
40.
41.
42. 4) disinfection
• Sterilization of instrument
• Disinfection of article used by patient
• Patients urine, faeces, sputum should be
properly disinfected
43. 5) Dust control
• Suppression
of dust by
wet dusting
& vacuum
cleaning
48. Hospital infection control committee
• Medical superintendent- chairperson
• Representative from major clinical
departments.
• Representative for nursing services.
• CSSD in charge.
• OT in charge.
• Microbiologist.
50. An attempt should be made to
achieve and maintain an average
count of 10-15 bacteria/cubic foot of
air in hospital
less than 5 bacteria/ cubic foot- minimal risk of infection
more than 35 bacteria/ cubic foot of air- heightened risk
51. Guideline to evaluate the floor
cleaning procedure
Based on rodac plate count
• 0-25 bacteria/cubic foot- good floor cleaning
procedure
• 26-50 bacteria/cubic foot- satisfactory
• More than 50 bacteria/cubic foot- not
satisfactory
52. Role of central sterile supply
department (CSSD)
• CSSD is an accepted feature of hospital
planning.
53. Function of CSSD
• Supply of sterile instrument & material for
dressing & procedure carried out in wards &
department.
• Sterilization of instrument & linen for use in
operation theatre
54. CSSD also look after
• Disinfection & sterilization of medical
equipment such as ventilators, baby
incubators, oxygen tents etc.
• Selection & distribution of single use
(disposable) sterile supplies such as catheters,
suction tubing & syringe.
67. References
• Park’s textbook of Preventive & social medicine
• Harrisons principle of internal medicine
• Textbook of microbiology: Ananthnarayana
• Bennett & Brachmans hospital acquired infection:
William R. Jarvis
• Hospital administration: Francis & De Souza
• www.burnsjournal.com date 09-07-2012
• www.ann-clinmicrob.com date 09-07-2012
• www.jornalofhospitalinfection.com date 09-07-
2012
• CSSD of UP RIMS&R Saifai, Etawah