Microbiology and

Parasitology Week 2
THE ANGELITE PRAYER
Almighty God, we glorify you for giving us the Angelite
Charism. We thank you for the gift of your Son, Jesus
Christ, who is the Way, Truth, and Life. We bless you for
the continuous guidance of the Holy Spirit.
Grant us, we pray, courage and strength that we may give
perpetual praise to you in whatever we do. We ask this
through Christ, our Lord. Amen.
Oh, Holy Guardian Angels, guide us and protect us!
Laus Deo semper!
HOSPITAL ACQUIRED INFECTION
aka
NOSOCOMIAL INFECTION
Core Value

SOCIETAL RESPONSIBILITY
NOSOCOMIAL INFECTIONS
• also known as “Hospital-acquired infection”

• infectious diseases acquired within the hospital or healthcare facility

• to include those that break out after 14 days of hospital discharge

• should NOT be present or incubating during hospital admission

NOSOCOMIAL INFECTIONS
• Community Acquired infections
• infectious diseases acquired
outside healthcare facilities
• Iatrogenic Infections
• “Physician-induced infection”
• caused by physicians or other
healthcare personnel
• infectious diseases that result
from medical or surgical treatment
• Pathogens most often involved
in nosocomial infections:
• mostly Opportunistic pathogens
• do NOT cause disease in healthy
people
• found among:
• patients themselves
• hospital employees
• hospital equipment
NOSOCOMIAL INFECTIONS
• Pathogens most often involved in nosocomial infections:
• majority are drug-resistant
Examples:
• Staphylococcus aureus
• Pseudomonas aeruginosa
• Escherichia coli
NOSOCOMIAL INFECTIONS
• types of nosocomial infections:
• Urinary tract infections (MC)
• Post-surgical wound infections
• Lower respiratory tract infections /
Pneumonia
• Bloodstream infections /
Septicemia
• Patients most likely to develop
nosocomial infections:
• elderly patients
• women in labor and delivery
• premature infants and newborns
• surgical and burn patients
• diabetic and cancer patients
• immunocompromised/immunosu
ppressed host
• paralyzed patients
• patients undergoing dialysis
NOSOCOMIAL INFECTIONS
• Patients most likely to develop nosocomial infections:
• patients with indwelling devices (IV tubing, Catheter, Tracheostomy tube, etc.)

• patients receiving treatment with

• steroids
• anti-cancer drugs
• anti-lymphocytes serum
• radiation
Patients most likely to develop Nosocomial
Infections
Patients most likely to develop nosocomial
infections
NOSOCOMIAL INFECTIONS
• Major contributing factors:
• Drug-resistant pathogens
• Immunocompromised/immunosu
ppressed host
• Chain of transmission in the
hospital
• failure to comply to infection control
guidelines
NOSOCOMIAL INFECTIONS
• Other factors:
• indiscriminate use of antimicrobials and immunosuppresants

• false sense of security about MO

• lengthy, complicated surgery

• overcrowding in hospitals

• ↑ use of less highly-trained health workers

• overuse and improper use of indwelling devices

INFECTION CONTROL
Measures to prevent infection from
occurring in healthcare facilities
Goal: To break various links in the
chain of infection, by:
• eliminating or containing reservoirs
• interrupting transmission
• protecting persons from being
infected
Control of nosocomial infections
• Handwashing
• single most important measure of
preventing the spread of infection
• Disinfection & sterilization
techniques
• Air filtration
• Use of UV lights
• Isolating infectious patients
• Wearing gloves, masks, & gowns
whenever appropriate
• Disposal of single-use items
INFECTION CONTROL
• Asepsis
• “Without infection”
• absence of contamination by pathogens
• includes any actions taken to prevent infection or break the chain of infection
(Aseptic technique)

• types:
• Medical asepsis
• Surgical asepsis
INFECTION CONTROL
• MEDICAL ASEPSIS • SURGICAL ASEPSIS
• “Clean technique” • “Sterile technique”
• goal: to reduce the number and • goal: eliminate all pathogens
transmission of pathogens
• Surgical aseptic techniques are
• Medical aseptic techniques practiced in:
include: • strictly practiced during invasive
• handwashing procedures
• personal grooming • operating rooms
• cleaning of supplies and equipment • labor and delivery rooms
• disinfection • laboratories
• proper disposal of contaminated or • patient’s bedside during recovery
infectious materials
STANDARD PRECAUTIONS
• Used for care of ALL hospitalized • Handwashing
patients, regardless of diagnosis • Gloves
• Eye shields and face shields
• Goal: To reduce the risk of • Surgical masks
transmission of pathogens in the
hospital setting • Gowns
• Patient-care equipment
• Applies to: • Linens
• blood • Environmental control
• all body fluids (except sweat)
• non-intact skin • Occupational health and blood-
• mucous membrane borne pathogens
• Patient placement
STANDARD PRECAUTIONS
HANDWASHING
• single most important measure of
preventing the spread of infection
• should be done:
• before & after each patient contact
• between tasks and procedures on the
same patient
• after touching body fluids &
contaminated items
• after removing gloves
HANDWASHING
• Antimicrobial soaps SHOULD be
used before entering the operating
room
• to be done for about 10 minutes
• plain soaps may be used for routine
handwashing
• also includes cleaning the
fingernails
• paper towels or air dryers should
be used
• alcohol-based hand rubs can be
used
STANDARD PRECAUTIONS
• GLOVES
• Must be worn when touching:
• mucous membrane
• non-intact skin
• body fluids
• contaminated items
• Must be changed:
• in between tasks
• in procedures on the same patient
• EYE SHIELDS and FACE SHIELDS
• worn during procedures that are
likely to generate splashes or
sprays of blood or any body fluid
• SURGICAL MASKS
• worn during procedures that are
likely to generate splashes or
sprays of blood or any body fluid
• protects the wearer from large
particle droplets
STANDARD PRECAUTIONS
STANDARD PRECAUTIONS
• GOWNS
• worn during procedures that are
likely to generate splashes or
sprays of blood or any body fluid,
or cause soiling of clothing
• wash hands after removing gown
STANDARD PRECAUTIONS
• PATIENT-CARE EQUIPMENTS
• reusable equipment should be
properly cleaned, disinfected, or
sterilized before using to another
patient
• dispose single-use items
• visibly contaminated articles
should be bagged
• LINENS
• linens that have been soiled with
body fluids must be handled,
transported, and processed in a
manner that prevents
contaminating yourself or your
clothing and prevents transfer of
MO to other patients and areas
• ENVIRONMENTAL CONTROL
• routine care, cleaning, and
disinfection should be observed by
all
STANDARD PRECAUTIONS
• OCCUPATIONAL HEALTH AND
BLOODBORNE PATHOGENS

• needle-stick injuries and injuries

resulting to broken glass or other
sharp objects
• primary manner in which healthcare
professionals become infected with:
• Hepatitis-B virus (HBV)
• Human Immunodeficiency virus
(HIV)
STANDARD PRECAUTIONS
• OCCUPATIONAL HEALTH AND BLOODBORNE PATHOGENS
• never recap used needles using two hands
• use one-handed scoop technique or a mechanical device that eliminates the danger of
sticking yourself with the needle

• do not remove used needles by hand

• do not bend or break used needles

• place all sharp objects in a appropriate puncture-resistant containers and

properly label the container
STANDARD PRECAUTIONS
• PATIENT PLACEMENT
• use private rooms for patients
who:
• contaminate the hospital
environment

• do not assist in maintaining

appropriate hygiene or environment
control
TRANSMISSION-BASED PRECAUTIONS
• uses standard precaution and some additional guidelines
• additional precautions beyond Standard precautions that are required
to interrupt transmission within hospitals

• includes:
• Air-borne precautions
• Droplet precautions
• Contact precautions
AIR-BORNE PRECAUTIONS
• designed for patients infected with
epidemiologically important
pathogens that can be transmitted
via airborne
• guidelines:
• room:
• private room with negative pressure
• if none, place patient with other
patients with the same pathogen but
with no other infection
• nurses and SO must wear masks
• patients should wear masks during
transport from the room
DROPLET PRECAUTIONS
• Designed for patients infected
with epidemiologically
important pathogens that can be
transmitted via droplet
• Can also occur during suctioning
and bronchoscopy
Guidelines:
• Room:
• private room with negative
pressure
• if none, with patients with the
same pathogen but with no other
infection
• persons working within 3 feet of
the patient must wear a mask
• patients should wear masks
during transport from the room
CONTACT PRECAUTIONS
• Designed for patients infected with
epidemiologically important
pathogens that can be transmitted
via direct or indirect contact
• Most important and most frequent
mode of transmission of
nosocomial infections
Guidelines:
• Room:
• private room with negative pressure
• if none, with patients with the same
pathogen but with no other infection
• wear gloves and gown (when?)
• wash hands (when?)
• limit transport of patient
• avoid sharing of equipment
ISOLATION
• types:
• Source isolation
• Protective isolation
ISOLATION
• SOURCE ISOLATION
• patients are placed in isolation to
protect OTHER people from
becoming infected

• the patient is the “source” of

infection
• the patient is highly contagious with
a life-threatening disease

• room should be under negative

pressure
ISOLATION
PROTECTIVE ISOLATION
• also known as:
• Reverse isolation
• Neutropenic isolation
• patients are placed in isolation to
“protect” THEMSELVES from
becoming infected or from
secondary infections
• patients have very weak immune
system or resistance
PROTECTIVE ISOLATION
• Placed in a Total Protective
Environment (TPE)
• room:
• private room
• should be cleaned & disinfected
• under positive pressure
• air filters
• items entering the room should be
disinfected or sterilized
• gowns, masks, gloves, caps, & shoe
covers must be worn
• handwashing
ISOLATION
How to handle Fomites:
• Use disposable equipment
whenever possible
• Disinfect equipment as soon as
possible after use
• Use individual equipment for each
patient
• Clean thermometers before and
after use
• Empty bedpans and urinals
• Place bed linen and soiled clothing
in bags
Medical Waste Disposal
• Preferably, needles should NOT
be:
• re-sheathed
• bent or broken by hand
• removed from disposable syringes
• manipulated by hand

• NEVER re-sheath needles using

both hands
• one-hand scoop technique
• mechanical device (forceps)
Medical Waste Disposal
• After use, needles, disposable
syringes, scalpel blades, and
other sharp items must be
placed in a puncture-resistant
container

• “Sharp containers” must be

easily accessible, located in
areas where needles are
commonly used