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

• CCC — Hand hygiene
• CCC — Ventilator associated pneumonia (VAP)
• CCC — Central line infections, CRBSI and CLABSI

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]