Nobel Technical Private Institute

Nursing Department
First Stage
Microbiology

CONTROL OF INFECTION

Prepared by: Fatima Omar Mohammed

Supervised by: Dr. Noor maamon khairi
00 TABLE OF CONTENTS

1. Introduction to infection control.

2. Chain of infection

3. The Spread of Infectious Disease

4. Epidemiological Triad

5. Infection Spread in Healthcare

6. Controlling Infectious Diseases Within Communities

7. Medical Interventions

8. Environmental Cleaning and Disinfection

9. Conclusion

10. Resources

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01 INTRODUCTION.

According to the World Health Organization (WHO), infection prevention and

control (IPC) is a scientific approach and practical solution designed to prevent
harm caused by infection to patients and health workers. It is a subset of
epidemiology, but also serves an essential function in infectious diseases, social
sciences and global health.

Effective IPC is a public health issue that is fundamental in patient safety and
health system strengthening. The prevention of healthcare-associated infections
(HAI), epidemics (including the 2013-2016 Ebola virus disease outbreak),
and pandemics of international concern (For Example; 2009 flu pandemic and
the coronavirus disease 2019) are rooted in effective IPC measures. A guiding
principle on WHO's Core Components of IPC is that "access to health care
services designed and managed to minimize the risks of avoidable HAI for
patients and health care workers is a basic human right".

Strengthening global IPC is essential to combat HAI, antimicrobial resistance,

and to respond to disease outbreaks. A study published in 2021 looked at the
WHO's Core Components of IPC and found that most participating countries
have IPC programmers and guidelines in place, however few have set aside the
necessary resources to support the programs. There is a need to move from the
planning stage into the implementation and monitoring stages, particularly in
low-income countries.

02 CHAIN OF INFECTION

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03 THE SPREAD OF INFECTIOUS DISEASE

An infection is defined as the successful transmission of pathogenic

microorganisms, such as bacteria, viruses, parasites or fungi that are spread:

 Directly:
o From person to person
o Through respiratory droplets (for example, coughing or sneezing)
o Through body fluids
o Direct exposure to infectious agent in environment
o During childbirth from mother to fetus (trans placental/perinatal)

 Indirectly:
o Biological - Vector or Intermediate host (for example; Zika Virus)
o Mechanical - Vector or Vehicle (for example; Plague -
transmission of Yersinia Pestis by fleas)
o Airborne (for example, Tuberculosis)

04 EPIDEMIOLOGICAL TRIAD

In humans, infections occur when an infectious microorganism enters the body,

multiplies, and leads to a reaction in the body and potential infectious disease. The
spread of infectious disease requires three variables, known as the epidemiological
triad:

 The Agent - The microorganism that causes the infection and can be in the
form of bacteria, viruses, parasites or fungi
 The Host - The target of the disease
 The Environment - The surroundings and conditions (these are external to the
host)

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05 INFECTION SPREAD IN HEALTHCARE

Healthcare facilities, whether hospitals or primary care clinics are an area with
an elevated risk of disease transmission due to the presence and relative ratio of
susceptible individuals. One in ten patients get an infection whilst receiving
care[10] yet effective infection prevention and control reduces healthcare-
associated infections by at least 30% [10]. In a healthcare setting, the three
components required for infection spread are the following:

 Source - places where infectious agents survive (e.g. sinks, hospital

equipment, countertops, medical devices).
o Environment - patient care areas, sinks, hospital equipment,
countertops, medical devices.
o People - patients, healthcare workers, or visitors.

 Susceptible Person - Someone (Patient, Healthcare Worker, or Visitor)

who is not vaccinated or immune to a particular infectious disease, or an
individual with a compromised immune system / immunodeficient .
o In addition, susceptibility can be heightened in individuals due to
underlying medical conditions, medications, and necessary
treatments and procedures that increase the risk of infection (for
example, surgery).

 Transmission - The way germs are moved to the susceptible person

o Touch, including via medical equipment or a susceptible person
(for example, MRSA or VRE)
o Sprays or splashes (for example, Pertussis)
o Inhalation of aerosolised particles (for example, TB or Measles)
o Sharps injuries introducing blood-borne pathogens (for
example, HIV, HBV, HCV)

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06 CONTROLLING INFECTIOUS DISEASES WITHIN COMMUNITIES

Infection control and prevention is a global issue and there are many protocols
and guidelines that can be followed to minimise the spread of infection between
people, within a population and globally. Identifying at-risk groups such as
children, older people and those with chronic conditions can also help guide
relevant strategies to protect these vulnerable groups. The first step when
looking at infection control can start at the community level by changing
behavior, including:

 Regular hand washing

 Appropriate use of Face-masks (protect from and prevent spread of
respiratory infections)
 Using insect repellents
 Ensuring up-to-date routine vaccinations and participating in
immunisation programmes
 Taking prescribed medications, such as antibiotics, as directed by health
professionals
 Social distancing - avoiding contact with others
 Using condoms when having sex, especially with a new partner

Other steps that can be taken to control the spread within communities include
environmental measures such as:

 Modifying environments
 Surveillance of diseases
 Food safety
 Air quality

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07 MEDICAL INTERVENTIONS

As well as simple steps to prevent and control infections, there are biochemical
interventions that can be implemented to speed up the recovery process and in
some cases prevent viral infections completely. The development of
antibiotics, antivirals and vaccinations have been shown to speed up recovery,
slow down the progression and in some cases eradicate infectious diseases from
entire populations.

 Antibiotics
Antibiotics are prescribed for bacterial infections and support the body's natural
defense system to eliminate the disease-causing bacterial agent. They are
designed to either kill bacteria or stop them from reproducing. However, poor
use of antibiotics, over-prescribing and the mutation of bacteria has led the
development of resistant bacteria. In these cases, either stronger doses are
required or the combination of one or more antibiotics.

 Vaccinations
Vaccinations are designed to improve immunity to a particular disease.
Vaccines work by introducing small amounts of the disease-causing virus or
bacteria into the host, allowing them to build up natural immunity. The
introduction of regular vaccines have slowed down and in some cases
eradicated certain diseases such as polio, measles, mumps, whooping cough
and rubeola (measles). There are also vaccinations for chickenpox, but this is
not given routinely and is reserved for those at risk of spreading the disease to
those with a weakened immune system. This is due to the fact that it is
prevalent in children under 10 years of age and symptoms are usually mild; this
method allows them to build up natural immunity and contributes to improving
the immunisation of a community. This type of protection is known as herd
immunity.

 Antivirals
Antibiotics provide no defence for infectious diseases that are caused by viral
agents such as influenza, HIV, herpes, and hepatitis B. In these cases, antiviral
medications are the most effective at slowing down the progression of the
disease and boosting the immune system. Unfortunately, as with antibiotics,
viruses can mutate over time and become resistant to these antiviral drugs.
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08 ENVIRONMENTAL CLEANING AND DISINFECTION

Evidence supports the important role of environmental cleaning in controlling

the transmission of organisms (e.g.Staphylococcus Aureus, Vancomycin-
resistant Enterococci, Norovirus, Clostridium Difficile and Acinetobacter),
especially in hospitals and healthcare settings.

If an individual with a suspected or confirmed case of infectious disease has

attended your clinic, all surfaces that the person has come into contact with
must be cleaned.

 The room where they were placed/isolated should not be cleaned or used
for one hour and the door to the room should remain shut.
 The person assigned to clean the room should wear gloves (disposable
single-use nitrile or household gloves) and a disposable apron (if one is
available) then physically clean the environment and furniture using a
household detergent solution followed by a disinfectant or combined
household detergent and disinfectant, for example, one that contains a
hypochlorite (bleach solution). Products with these specifications are
available in different formats including wipes.
 No special cleaning of walls or floors is required.
 Pay special attention to frequently touched flat surfaces, backs of chairs,
couches, door handles or any surfaces that the affected person has
touched.
 Discard waste (including used tissues, disposable cleaning cloths) into a
healthcare risk waste bag (yellow).
 Remove the disposable plastic apron (if worn) and gloves and discard
into a healthcare risk waste bag.
 If a healthcare risk waste bag is not available, place the waste in a small
household waste bag and tie securely. Do not overfill. Then place the bag
in a second household waste bag and tie securely. Store in a safe
location. If the case is not confirmed the waste can be disposed of as per
usual. If a case is confirmed public health will then advise you what to do
with the waste.
 Once this process has been completed and all surfaces are dry the room
can be put back into use.

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09 CONCLUSION

There is no one solution to controlling the spread of infectious diseases, and

effective IPC indeed requires government intervention and collaboration
between healthcare agencies, individuals and communities. Until certain risk
factors are addressed and behaviors modified, the war against infectious
diseases will continue to be a predominant and costly health issue around the
world.

10 RESOURCES

https://www.cdc.gov/hai/prevent/infection-control-assessment-tools.html

https://www.publichealthontario.ca/-/media/documents/checklist-clinical-office-
core.pdf?la=en

https://www.england.nhs.uk/publication/national-infection-prevention-and-control/