INFECTION

PREVENTION AND
CONTROL (IPC)
Introduction to Health Care-Associated Infections

• Disease transmission cycle describes the six components

required for the spread of an infectious organism to a
susceptible host.
• The essential components in the cycle are: agent
(disease-producing microorganism), reservoir
(place where agent lives this includes humans,
animals, plants, soil, air, water), mode of escape
(how the agent exits the reservoir), mode of
transmission, place of entry, and susceptible host.
• Each of these components must be present for the
infection to be transmitted.
Health care-associated infection (HAI)

• This is an infection that occurs in a patient as a

result of care at a health care facility and was
not present at the time of arrival at the facility.
• To be considered an HAI, the infection must
begin on or after the third day of admission to
the health care facility (the day of admission
is Day 1) or on the day of or the day after
discharge from the facility.
 Resident flora
• These are microorganisms that live in the deeper
layers of the skin and within hair follicles and
cannot be completely removed, even by vigorous
washing and rinsing with plain soap and clean
water.
• In most cases, resident flora are not likely to be
associated with infections; however, the hands or
fingernails of some health care workers (HCWs) can
become colonized by microorganisms that do cause
infection (e.g., Staphylococcus aureus, gram-
negative bacilli, or yeast), which can be
transmitted to patients.
 Transient flora
• These are microorganisms acquired through
contact with individuals or contaminated
surfaces during the course of normal, daily
activities.
• They live in the upper layers of the skin and are
more amenable to removal by hand hygiene.
• They are the microorganisms most likely to
cause HAIs.
 Standard Precautions
• These are a set of infection prevention and
control practices (IPC) used for every patient
encounter to reduce the risk of transmission of
blood borne and other pathogens from both
recognized and unrecognized sources.
• They are the basic level of IPC practices to be
used, at a minimum, in preventing the spread of
infectious agents to all individuals in the health
care facility.
 Transmission-Based
Precautions
• These are additional precautions, used along
with Standard Precautions, used to reduce the
risk of airborne, droplet, and contact
transmission of infection among hospitalized
patients and HCWs when the disease
transmission cycle is not completely interrupted
using Standard Precautions
 BACKGROUND
• A health care-associated infection is an infection
that occurs in a patient as a result of care at a
health care facility and was not present at the
time of arrival at the facility.
• The term “health care-associated infection”
replaced “nosocomial” or “hospital-
acquired” infection as evidence has shown that
these infections can affect patients in any setting
where they receive health care.
• The HAIs can be defined as infections that begin
on or after Day 3 of hospitalization (the day of
Health care-associated
infections of Hospital and Public
health Concern
Health care-associated infections can affect the
cardiovascular, respiratory, gastrointestinal, and
genitourinary tracts, central nervous systems, and
bones and joints. HAIs may also affect skin, soft
tissues, and muscles. HAIs of concern in many
hospital settings include:
• Urinary tract infection (UTI), including catheter-
associated urinary tract infection (CAUTI)
• Blood stream infection, including central line-
associated bloodstream infection (CLABSI)
Cont...
• Surgical site infection (SSI)
• Pneumonia, including ventilator-associated
pneumonia (VAP)
• Multidrug-resistant infections
• Infectious Diarrhea and Clostridium difficile
infections
Contributing Factors for Health Care-Associated Infections

• Anyone can acquire an HAI while receiving care but

certain patient groups are at higher risk (e.g.,
newborns, elderly patients, and patients with
underlying diseases that compromise their immune
systems and make them chronically ill, such as HIV).
• There are many factors associated with the
occurrence of HAIs at a health care facility,
including the infrastructure, available resources,
staff compliance with IPC standards, and the type of
patients treated.
Factors found to contribute to HAIs in Health settings include:

• High patient-to-nurse/practitioner ratio

• Bed space less than 1 meter (3 feet) apart
• Low compliance with hand hygiene practices
• Lack of resources including rooms for isolation or
cohorting (grouping together patients with the
same infection)
• Lack of trained IPC practitioners and limited
opportunities for staff training
 Factors....
• Increasing use of complex medical and surgical
procedures
• Increasing use of invasive medical devices (e.g.,
mechanical ventilators, urinary catheters, central
1intravenous lines) without proper IPC training or
laboratory support .
• Inadvertent contamination of prepared
supplies/pharmaceuticals (e.g., IV fluid, infant
formula, general medications)
• Suboptimal cleaning, disinfection, and
sterilization practices
• Antibiotic resistance due to overuse of broad-
Interventions to Prevent Health
Care-Associated Infections
Knowledge about ways to break the disease
transmission cycle can assist health care facilities
in putting together prevention strategies to stop
the spread of infections.
Key interventions for prevention of HAIs include:
• Establishing systems to track targeted HAIs in a
health care facilities.
• Having dedicated staff for IPC and tracking of
HAIs
• Fully adhering to recommended general IPC
THANK YOU