Healthcare

Associated Infection
BY: yousra Alghalban
 Healthcare Associated
Infection
• Are any infection acquired during hospitalization or attending any health
care outlet. They are neither present nor incubating at time of hospital
admission, they first appear 48 hours or more after hospitalization or 3 days
of discharge or 30 days of an operation.

• These infections occur in all types of care settings, including:

- Acute care hospitals.
- Dialysis facilities.
- Outpatient care (e.g., physicians' offices and health care clinics).
- Long-term care facilities (e.g., nursing homes and rehabilitation facilities
 Types of Healthcare Associated
Infection
1. Catheter-associated urinary tract infections (CAUTI).

2. Surgical site infections (SSI), infections that may occur at surgery sites.

3. Ventilator-associated pneumonia (VAP).

4. Central line-associated bloodstream infections (CLABSI).

 Predisposing factors

1. Factors related to the patient

2. Factors related to the agent

3. Factors related to the environment

 Predisposing factors (patient)
1. Age Extremes of age are highly susceptible.
2. Nutritional status: Malnutrition lowers general resistance.
3. Social class: Lower social classes are more liable to infection.
4. Nature and severity of underlying diseases: Certain diseases like diabetes
mellitus, burns, late stages of carcinomas...etc. increase susceptibility to
infection.
5. Potent medications: as corticosteroids, immunosuppressive drugs and
improper use of antibiotics.
6. Some procedures: affect the normal host defense mechanisms (integrity of
skin and mucous membrane barriers) as operative procedures, intravenous
catheter...etc.
 Predisposing factors (agent)

• The emergence of drug-resistant strains.

• Alteration in antigenic identity.

• Evolution of virulent strains

 Predisposing factors
(environment )
Increases exposure to potentially pathogenic organisms derived from:

• Cross-infection from other cases.

• Asymptomatic hospital personnel acting as carriers.

• Lack of proper sanitation, disinfection and food and insect control

Predisposing factors
 Reservoir of Infection
Persons within the hospital:
• Patients (cross and endogenous infection).
• Hospital staff: They are usually asymptomatic carriers (who carry organisms
in nostrils, mouth cavity, skin or clothes).

2- Persons outside hospital: Visitors of the patients (carriers or cases) and

other persons contaminating hospital environment then infections are
transmitted by different vehicles and vectors.

3- Hospital environment: • Especially with lack of active measures for

sanitation and antisepsis.
 Mode of Infection
1- Direct contact with a case or a carrier: As by droplets during sneezing, coughing,
blowing the nose, laughing and loud talking. It includes:

a) Cross infection (patient to susceptible individual or to patient).

b) Physical contact as scabies.

The most important and frequent mode of transmission of nosocomial infections is by

direct contact.

2- Indirect contact by:

a) Air-born infection in the form of droplet nuclei and dust particles

b) Articles and fomites: e.g. Blankets, bed linen, clothes, masks, improperly disinfected
thermometers, needles and syringes, surgical dressing and food
 Clinical forms
1- Urinary tract infection : about 40% of infections

2-Surgical wound infection

3- lower respiratory tract infection

4-Bacteremia

5- Diarrheal disease

6- Others: e.g. puerperal sepsis, neonatal infection, osteomyelitis& meningitis.

Infection control measures
Infection control measures
Infection control measures
Infection control measures
Infection control measures