Healthcare Associated Infections

Reviewed and revised 6 June 2015

OVERVIEW

  • Healthcare associated infections (HAIs) are infections acquired in healthcare facilities and infections that occur as a result of healthcare interventions, which may manifest after people leave the healthcare facility
  • Each year in Australia there are about 200,000 HAIs
  • they are potentially preventable adverse events
  • reducing HAI is the responsibility of all healthcare workers

COLONISATION VERSUS INFECTION

  • Colonisation is the sustained presence of replicating infectious agents on or in the body without the production of an immune response (infection) or disease, and is a potential source of transmission
  • Infection is the successful transmission of microorganisms to the host with subsequent multiplication, colonisation and invasion. Infection may be clinical or subclinical and may not produce identifiable disease

SOURCE

  • either resident or transient flora on skin, acquired through direct contact or from the environment (e.g. droplet, airborne)
  • either endogenous (from the patient) or exogenous (from others or the environment)

TRANSMISSION

  • contact is direct (from one person to another) or indirect (from one person via another or the environment to another)
  • droplets from cough or breathing
  • airborne from aerosolized secretions
  • environmental (e.g. contaminated food, water, medications, devices or equipment)

ORGANISMS

  • bacteria
  • viruses
  • fungi

VULNERABLE PATIENTS

  • severe underlying medical disease (e.g. immunosuppression)
  • recent surgery
  • indwelling devices (e.g. urinary catheters or endotracheal tubes)

References and links

LITFL

Journal articles and textbooks

  • Burke JP. Infection control – a problem for patient safety. N Engl J Med. 2003;348:(7)651-6. [pubmed]
  • Carter EJ, Pouch SM, Larson EL. Common infection control practices in the emergency department: a literature review. Am J Infect Control. 2014;42:(9)957-62. [pubmed]
  • Marcel JP, Alfa M, Baquero F, et al. Healthcare-associated infections: think globally, act locally. Clin Microbiol Infect. 2008;14:(10)895-907. [pubmed]

CCC 700 6

Critical Care

Compendium

Chris is an Intensivist and ECMO specialist at the Alfred ICU in Melbourne. He is also the Innovation Lead for the Australian Centre for Health Innovation at Alfred Health and Clinical Adjunct Associate Professor at Monash University. He is a co-founder of the Australia and New Zealand Clinician Educator Network (ANZCEN) and is the Lead for the ANZCEN Clinician Educator Incubator programme. He is on the Board of Directors for the Intensive Care Foundation and is a First Part Examiner for the College of Intensive Care Medicine. He is an internationally recognised Clinician Educator with a passion for helping clinicians learn and for improving the clinical performance of individuals and collectives.

After finishing his medical degree at the University of Auckland, he continued post-graduate training in New Zealand as well as Australia’s Northern Territory, Perth and Melbourne. He has completed fellowship training in both intensive care medicine and emergency medicine, as well as post-graduate training in biochemistry, clinical toxicology, clinical epidemiology, and health professional education.

He is actively involved in in using translational simulation to improve patient care and the design of processes and systems at Alfred Health. He coordinates the Alfred ICU’s education and simulation programmes and runs the unit’s education website, INTENSIVE.  He created the ‘Critically Ill Airway’ course and teaches on numerous courses around the world. He is one of the founders of the FOAM movement (Free Open-Access Medical education) and is co-creator of litfl.com, the RAGE podcast, the Resuscitology course, and the SMACC conference.

His one great achievement is being the father of two amazing children.

On Twitter, he is @precordialthump.

| INTENSIVE | RAGE | Resuscitology | SMACC

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