Hospital Infection Control Flashcards
HAI and it’s types
Any infection developing in a patient after 2 days of hospitalisation can be labelled as health care associated infection.
1) catheter associated urinary tract infection.
2) catheter related bloodstream infection
3) ventilator associated pneumonia
4) surgical site infection
Catheter associated urinary tract infection
The most common cause of these infections is E.coli but other gram negative bacilli such as klebsiella pseudomonas acinetobacter and enterococcus can also cause this infection.
Pathogenesis
Device related
Patient related
Care giver related
Extra luminal or intraluminal surface of catheter
Diagnosis is by recent catheterization within 24 hours or by urine culture or presence of any clinical criteria of urinary tract infection such as fever, suprapubic tenderness.
Catheter related bloodstream infection also called as Central line associated bloodstream infection
Pathogenesis can be due to migration of patients skin flora to the tip of catheter or direct contamination of the catheter by the hands of healthcare workers or through hematogenous root from focus of infection or contamination of the device or fluid.
Diagnosis is by blood culture from Central line and peripheral line or by clinical criteria such as fever childs rigor or hypotension after insertion of Central line or science of caterer site infection such as erythema, tenderness swelling at the catheter site exit.
Ventilator associated pneumonia
Pathogenesis of ventilator associated pneumonia includes colonization followed by endotracheal intubation which is followed by biofilm formation leading to subglotic secretions.
Diagnosis is by gram staining for culture and radiological diagnosis can also be done.
Surgical site infection
It can occur by indigenous source such as patients own flora like staphylococcus aureus, e-coli.
Exogenous source includes klebsiella, enterococcus ,bacteroids.
Pathogenesis includes patient related factors such as age more than 60 years or men nutrition and procedure related like prolonged operative time and organism related like large inoculam size and environment related such as presence of blood or plot or any suture material
Sequential steps to be followed after needle stick injury.
1) first aid
2) report to the designated nodal centre
3) take first dose of post exposure prophylaxis for HIV
4) testing of bloodborne viruses
5) decision on post exposure prophylaxis
6) informed consent and counselling
7) documentation and recording of exposure
8) follow up testing
9) precautions during the follow up period
