Hospital_acquired_infection.ppt for scienific

Very good lecture

1. Hospital acquired Hospital acquired
infectioninfection

2. Hospital acquired infectionHospital acquired infection
Also called nosocomial infection.Also called nosocomial infection.
 (noso: study of disease, comial: the area (noso: study of disease, comial: the area
from which infection acquired). from which infection acquired).
It’s infection which the patient acquires It’s infection which the patient acquires
during his stay in hospital or after he during his stay in hospital or after he
leaves the hospital. leaves the hospital.
Nowadays, it is very important and it cost Nowadays, it is very important and it cost
life and money. life and money.

3. Infection spread need three factors:Infection spread need three factors:
1.1.Source of the organism:Source of the organism:
Endogenous or auto-infections (from Endogenous or auto-infections (from
normal flora of the same patient e.g. normal flora of the same patient e.g.
E. coliE. coli, , StaphStaph… etc. … etc.
Exogenous from many sources of Exogenous from many sources of
hospital environment (e.g.hospital environment (e.g. from doctor or from doctor or
nurses). nurses).

4. Infection spread need three factors:Infection spread need three factors:
2. Susceptible host: 2. Susceptible host:
There are many factors that make the patient There are many factors that make the patient
susceptible to infection, such as: susceptible to infection, such as:
Surgery because it break the first defense line. Surgery because it break the first defense line.
Catheters- canulation-drug in using (2 types). Catheters- canulation-drug in using (2 types).
Drugs that inhibit the normal flora. Drugs that inhibit the normal flora.
Drugs that causing immunosuppressant Drugs that causing immunosuppressant
(Cortisol) (Cortisol)  organ transplantation. organ transplantation.

5. Infection spread need three factors:Infection spread need three factors:
3.3.Mode of transmissionMode of transmission: Through RT, GIT, : Through RT, GIT,
vehicles, direct contact (most important). vehicles, direct contact (most important).
Important system: UT (U.T.I). Important system: UT (U.T.I).
RT (RTI). RT (RTI).
Skin and wound infection. Skin and wound infection.
Foreign bodies related infection. Foreign bodies related infection.
GIT infection. GIT infection.
Infection through blood product. Infection through blood product.

6. Causative agentCausative agent::
UTI: UTI:
E. coliE. coli, drug resistant G-ve , drug resistant G-ve bacillibacilli
((Klebsiella, SerratiaKlebsiella, Serratia macroscusmacroscus) & ) &
Pseudomonas Pseudomonas usually followed the usually followed the
catheterization. catheterization.
Usually HAI start as a local infection and Usually HAI start as a local infection and
then complicated to septicaemia, so fever then complicated to septicaemia, so fever
is the most important symptoms is the most important symptoms

7. Causative agentCausative agent::
RTI:RTI:
 Acquired in patient with mechanical Acquired in patient with mechanical
ventilation or comatose patient (because ventilation or comatose patient (because
many mechanical procedure done to many mechanical procedure done to
him). him).
Klebsiella, drug resistance Klebsiella, drug resistance G-ve bacilliG-ve bacilli, ,
Enterococci, LegionellaEnterococci, Legionella and and
PseudomonasPseudomonas. .

8. Causative agentCausative agent::
Skin and wound infection: Skin and wound infection:
S. aureusS. aureus (mainly), (mainly), PseudomonasPseudomonas, ,
C. perfringens and Bacteroids & drug C. perfringens and Bacteroids & drug
resistance G-ve bacilli.resistance G-ve bacilli.
 Important strain of Important strain of StaphStaph that causes that causes
HAI (methicillin resistant HAI (methicillin resistant S. aureusS. aureus). ).

9. Causative agentCausative agent::
Foreign bodies related infections: Foreign bodies related infections:
Include catheter-canulation-tubes.Include catheter-canulation-tubes.
 Serious infection caused by non-Serious infection caused by non-
pathogenic organism, as pathogenic organism, as S. ablusS. ablus, ,
diphtheroides, diphtheroides, CandidaCandida. .

10. Causative agentCausative agent::
GIT infections: GIT infections:
 Can be caused by different types of Can be caused by different types of
organisms that cause GITI.organisms that cause GITI.
Important HAI is Important HAI is C.difficileC.difficile (toxigenic (toxigenic ClostridiaClostridia) )
cause serious infection called cause serious infection called
Pseudomembraneous colitis and some time Pseudomembraneous colitis and some time
called antibiotic associated diarrhoea.called antibiotic associated diarrhoea.
Also can be cause by Also can be cause by S. aureusS. aureus or or Candida Candida
albicansalbicans. .

11. Causative agentCausative agent::
Infection through the blood product: Infection through the blood product:
Most important HIV, HB virus. Most important HIV, HB virus.

12. The role of the lab in HAIThe role of the lab in HAI::
Isolation and identification of the Isolation and identification of the
causative agent. causative agent.
Sensitivity testing to the causative agent. Sensitivity testing to the causative agent.
Detection of the reservoir (source of Detection of the reservoir (source of
infection). infection).
Typing for epidemiological studies Typing for epidemiological studies
(identification of the organism to the (identification of the organism to the
strain levels. strain levels.

13. Collection of specimens:Collection of specimens:
From: From:
Persons: From all people on ward (patients and Persons: From all people on ward (patients and
workers in hospital staff). Take specimen from workers in hospital staff). Take specimen from
skin, hair, throat and nose. Moist the swab skin, hair, throat and nose. Moist the swab
before collect hair swab by sterile D.W. The best before collect hair swab by sterile D.W. The best
part of the skin to collect specimen from back of part of the skin to collect specimen from back of
the wrist. the wrist.
Furniture: floor, equipment by using moisture Furniture: floor, equipment by using moisture
swabs. swabs.

14. Collection of specimensCollection of specimens::
Sample from textiles (cotton, gauze). Take Sample from textiles (cotton, gauze). Take
small pieces by sterile forceps and then press small pieces by sterile forceps and then press
it on the surface of agar plate. it on the surface of agar plate.
Lotions (fluid): amount of fluid added to Lotions (fluid): amount of fluid added to
peptone water, then subculture from it.peptone water, then subculture from it.
From air: by one of the following methods: From air: by one of the following methods:
Settle plates (exposed BA plates): Put Petri Settle plates (exposed BA plates): Put Petri
dishes containing an agar medium on known dishes containing an agar medium on known
surface and left open for a measured period of surface and left open for a measured period of
time. Large bacteria carrying dust particles time. Large bacteria carrying dust particles
settle on the medium. settle on the medium.

15. Collection of specimensCollection of specimens::
Slit sampler (air slitter): it drawn in air Slit sampler (air slitter): it drawn in air
from the environment (by -ve pressure) at from the environment (by -ve pressure) at
the surface of an agar plate. the surface of an agar plate.
Air centrifuge. Air centrifuge.
Surface air system (SAS). Surface air system (SAS).
Settler plates: Settler plates:
Advantage: simplicity.Advantage: simplicity.
Disadvantages: Disadvantages:

16. Collection of specimensCollection of specimens::
Measure only the rate of deposition of large Measure only the rate of deposition of large
particles from air, not the total number of large particles from air, not the total number of large
and small bacteria carrying particles suspended and small bacteria carrying particles suspended
in it. in it.
Slit sampler: Slit sampler:
Advantage: it gives count of organism in amount Advantage: it gives count of organism in amount
of air per hours (sensitive). of air per hours (sensitive).
Disadvantage: Noisy. Disadvantage: Noisy.
Incubation: in all HAI incubate some plates Incubation: in all HAI incubate some plates
aerobically and others anaerobically. aerobically and others anaerobically.

17. PrecautionsPrecautions::
Wear full length plastic coat (best to be Wear full length plastic coat (best to be
disposable). disposable).
Wear gloves.Wear gloves.
Use mask. Use mask.
Hat. Hat.
Over shoes. Over shoes.

18. The end