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Home | CCC | Healthcare Associated Infections

Healthcare Associated Infections

by Dr Chris Nickson, last update April 24, 2019

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]

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About Dr Chris Nickson

An oslerphile emergency physician and intensivist suffering from a bad case of knowledge dipsosis. Key areas of interest include: the ED-ICU interface, toxicology, simulation and the free open-access meducation (FOAM) revolution. @Twitter | INTENSIVE| SMACC

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