HSS 1100 Lecture Notes - Lecture 10: Urinary Catheterization, Hospital-Acquired Infection, Sepsis
29 Apr 2018
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Department
Course
Professor
Nosocomial (Hospital-Acquired Infections)
Intro
• Infections acquired by a patient during hospitalization and having its origin in the hospital
environment or in a medical procedure
o Do not include infections that were already present or incubating upon admission to the
hospital
o May manifest itself after discharge
• Common in up to 25% of patients administered to hospital
• Most common infections: urinary tract, respiratory, wound, skin, soft tissue, septicemia
• Septicemia Not as common
Preventable vs Non-preventable
• Preventable = Medical, nursing, or surgical mishaps
o Ex. Breaches in aseptic procedure in surgery, improper hand washing
• Non-preventable = Beyond your control and sometimes cause you to take shortcuts which will
be of less risk
o Ex. Infection in the immunodeficient, surgeries where organs are seriously damaged,
gunshot/stabbing to GI tract
Where do these things come from?
• SOURCES OF HOSPITAL ACQUIRED INFECTIONS:
• Person to person spread (Direct contact)
o Endogenous = virus that was already present within the person before they arrived in
the hospital
o Exogenous = virus that was picked up by another person from outside the body in the
hospital setting
• Inanimate environment
• Non-refrigerated food
o Iue syste is’t ery strog
o Exposed to a pathogen, will most likely get sick bcs immune system is compromised
• Water reservoir
o Bacteria like moist, aqueous environments
o Ex. Legionella, Pseudomonas aeruginosa
• Air supply
o Filled with many pathogens
o Hospitals use air filtration systems to try and filter them out
o Improperly sterilized solutions
• Fomites (Indirect contact)
o Similar to vectors but with Inanimate objects
▪ Ex. pencil, clothing, ties on doctors
• Vector
o Living organism that serves as an agent to transfer a pathogen from one host to another
▪ Ex. mosquitos
find more resources at oneclass.com
find more resources at oneclass.com
Obvious Problems
• Medical procedures/activities can cause problems
o Intravenous access
o Urinary catheters
o Surgeries
• 3 Factors that play a role in the transmission of nosocomial infections
• Chain of Infection (Factors that play a role in infection)
o SOURCE ROUTE OF TRANSMISSION HOST
▪ Exogenous or Endogenous
o Source: location where organism replicates and spread/disperse
o Route of Infection: way the organism leaves the source to get to host
▪ Direct contact (person to person)
▪ Indirect contact (fomites inanimate objects)
▪ Vectors
▪ Water or food
o Host: How susceptible are you? age? immune status?
▪ Susceptible host individual infected with a microorganism carried from the
source via on the of the routes of transmission
Control over nosocomials
• Aim of hospital infection control programs is to interrupt the chain of infection from the source
to the host
o Render the source non-infectious by preventing the organism from leaving the source
o Interfering with the traveling of the infectious agents through the different routes of
transmission
o Prevent microorganism form entering the host or rendering the host resistant to
infection
• Most efficient step is identification and detection of the source
o Identify the strain specific pathogen
o From the environment or from the hospital
Source:
- detect the source
- isolate infected individuals
- eliminate inanimate sources or pets
Route of transmission:
- sterilization
- disinfection
- proper medical techniques
- ventilation
Host:
- Asepsis (in surgery)
- vaccination and protective isolation
find more resources at oneclass.com
find more resources at oneclass.com
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HSS 1100 Full Course Notes
Verified Note
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Document Summary
Preventable vs non-preventable: preventable = medical, nursing, or surgical mishaps, ex. Breaches in aseptic procedure in surgery, improper hand washing: non-preventable = beyond your control and sometimes cause you to take shortcuts which will be of less risk, ex. Infection in the immunodeficient, surgeries where organs are seriously damaged, gunshot/stabbing to gi tract. I(cid:373)(cid:373)u(cid:374)e syste(cid:373) is(cid:374)"t (cid:448)ery stro(cid:374)g: exposed to a pathogen, will most likely get sick bcs immune system is compromised, water reservoir, bacteria like moist, aqueous environments, ex. Legionella, pseudomonas aeruginosa: air supply, filled with many pathogens, hospitals use air filtration systems to try and filter them out. Improperly sterilized solutions: fomites (indirect contact, similar to vectors but with inanimate objects, ex. pencil, clothing, ties on doctors, vector, living organism that serves as an agent to transfer a pathogen from one host to another, ex. mosquitos. Obvious problems: medical procedures/activities can cause problems.
