Hospital Acquired Infections

Sarah Duffy

It is commonly thought that hospitals are better

off now than they were in past decades. While this

may be true, we are still learning about the

microorganisms that can spread and cause

widespread illnesses in medical centers. Infections

are still passed from doctor to patient and from

patient to patient paired with misused of

antibiotics, causing resistance that is more harmful to

the population in and out of the hospital than the

initial infection.

Reasons to be Concerned

• The increased number of hospital acquired

infections has generated a great amount of

attention in the past two decades

• Most of these infections are preventable

• Many HAIs have become resistant to

available antibiotics

"Nosocomial infections are a fact of life in healthcare

right now - as one infection may decline, a new infection

appears or there is an increase in the incidence of

another, speed is essential in identifying these

infections, and there are a host of tests out

there, targeting specific infections and offering fast

results.―- Bruce Carlson, publisher of Kalorama Information.

What is a Hospital Acquired Infections?

• A hospital acquired infection (HAI), or known in medical

literature as a nosocomial infection, is an infection that is

developed in a hospital and is acquired by a patient or

spread through the staff.

– Such infections include fungal and bacterial infections and are

contracted by patients because of their reduced resistance.

"Every year nearly two million hospital-acquired

infections claim roughly 100,000 lives and add

$45 billion in costs; that is as many lives and

dollars as taken by AIDS, breast cancer and

auto accidents combined-Jeneen Interlandi, Hospital Acquired Infections: Beating

Back the Bug

Who Contracts HAIs?

• HAIs can be picked up by anyone who visits

a hospital

• Patients with a suppressed immune system

are most susceptible to hospital born

infections

– HAIs are most dangerous for intensive car

patients and those recovering from surgery

• Hospital staff may also contract infections

Transmission of Infections • Infections can spread through the air and touch.

Healthy people can fend them off with mild illness but

someone with a compromised immune system or an

open wound would have a higher risk of prolonged

illness or even death.

• The two most common forms of transmission are

through the air and touching surfaces in the hospital.

Transmission Continued

Airborne

• Some infection germs

may be airborne and

transmitted by coughing

or sneezing.

• Infections can be spread

by patients

– Cough or sneeze germs to

another patient.

Touch

• Every surface in the hospital

can potentially carry house

infectious bacteria.

– Telephones

– Door knobs

– Catheters used in patients

– Bed linens

– Bathrooms

• Infections that are introduced

through tools and devices like

surgical instruments or

catheters.

This graph shows the primary sources of health-

acquired infections (HAI)

Most Common Infections

• Ventilator-associated

pneumonia

• Methicillin resistant

Staphylococcus aureus

• Clostridium difficile

• Tuberculosis

• Urinary tract infection

• Hospital-acquired

pneumonia

• Gastroenteritis

• Legionnaires' disease

Antibiotic Resistance

• Antibiotic resistant is, in

a way, a bigger issue

than hospitals acquired

infections.

• Antibiotic resistance

can be caused by a

number of things. The

biggest factor is

improper use of

antibiotics.

• Ineffective use of

disinfectants can also

allows the bacteria to

build up an immunity to

the disinfectant.

Gram-negative Bacteria

• Most bacteria are classified into two

groups— Gram-positive or Gram-negative —

depending which stain color they retain.

– Gram-positive will retain a purple dye, gram-

negative will retain a red or pink dye.

• Gram-negative bacteria is the cause of

infections like E. coli.

Bacteria can be classified as Gram-negative if it

retains a red or pink dye. If the bacteria retains a

purple dye, it is Gram-positive.

Gram-negative Bacteria and Drug Resistance

• Certain types of Gram-negative

bacteria have become

increasingly resistant to the

antibiotics available. Some

strains are now resistant to most

or all available treatments.

• Many Gram-negative bacterial

infections are transmitted

through cross-contamination

between people.

• Gram-negative infections like

Klebsiella, a bacteria that causes

pneumonia, urinary tract

infections, and bloodstream

infections, can enter the body in

a number of ways

– Urinary and intravenous

catheters

– Wounds

– ventilators

Gram-negative Bacteria Prevention

• With the increasing resistance to

antibiotics, Gram-negative infections have

become a major concern in

hospitals, nursing homes and other health

care facilities.

• One of the most important ways of

preventing the spread gram-negative

bacteria is simple sanitation techniques.

Statistics

• In the United States, the most common form

of infection is a urinary tract

infection, followed by surgical site

infection, bloodstream infection and

pneumonia.

• Annually, the cost to treat HAIs reached

close to $11 billion.

Statistics

• 70% of hospital-acquired infections are

resistant to at least one antibiotic

• 2007 study found that 85% of all invasive

MRSA infections were associated with

healthcare.

Current Prevention Procedures

• The current ways of preventing the spread of

infections in hospitals includes:

– Hand washing

– Gloves

– Gowns

– Intensive cleaning of all surfaces and

insturments.

Better ways of prevention

• A major contributing

factor to the

transmission of

diseases inside

hospitals is ineffective

sanitation.

• More conscious hand

washing, surface

cleaning, patient

interactions and wound

cleaning.

Cleaning in unnoticed places

• It is much easier to

clean large, wide

surfaces than small

buttons and switches.

• More attention to sites

like these could cut

down on bacteria

transferred by touch.

What more can be done?

• The proper use of

disinfectant sprays and

wipes

• Better and more

frequent hand washing

• Care use and

instruction on the

proper dosage of an

antibiotic for patients

• Find a universal

system for measuring

hospital cleanliness

• More attention to high

risk sites

• More invasive

inspections

– Visual inspections can

only see so much