Health Care Associated Infections and Infection Control

Resources• Lecture – nosocomial infections

▫ Lots of stuff about bacteria• Infection control in health care facilities – chapter 13

▫ Long▫ Really quite good

• Australian Guidelines for the Prevention and Control of Infection in Healthcare▫ I read the executive summary which is still really long.▫ Really terribly boring. I can’t imagine an exam

question really related to the stuff in this document.• Summary on blackboard

▫ Along with the lecture probably sufficient

Terminology

•Health Care Associated Infections – HCAIs

•Hospital Acquired Infections – HAIs•Throughout history drastic decreases in

mortality and morbidity have been made through advances in hygiene.

•There still an awful lot of work to do.

It is quite a problem.

•HAIs are the most common hospital complication.

•Costs and issues:▫Morbidity and mortality▫Increase in hospital stay▫Cost of antimicrobial therapy▫Reduced productivity▫Insurance claims▫Additional reservoir for the infection

Statistics• 200,000 HAIs leading to 7000 deaths (2003).• $268 million per year for surgical site infection

(2003).• $686 million per year for blood stream

infections (2003).• 2 million bed days per anum (2003).• You’ll notice these are widely different to those

in the summary. We’ve improved.• Most common HAIs

▫UTIs, surgical wounds, lower respiratory tract, skin, blood

Causes

•What bacteria have been responsible for HAIs have changed over the years.

•Many infections are now due to resistant bacteria.

•MRSA, VREF, ESBL, CDAD, VRSA, VISA etc

•Viruses – norovirus, rotavirus, cytomegalovirus, herpes simplex, RSV

•Fungi – candida, aspergillus funigaus