Description and burden of HAIs as a category
What are healthcare-associated infections?
Infections acquired in healthcare settings or as a result of healthcare interventions
What is clostridiodes difficile?
A gram-negative, anaerobic bacteria that forms spores and is ubiquitous in soil
What is ventilator-associated pneumonia?
Colonization of an endotracheal or tracheostomy tube allowing the delivery of bacteria into the lungs––the bacteria may be present in the body prior to or after ventilation
What are central line infections/how are they caused?
Bacteria migrate across the skin over the course of 7-10 days along catheter into intravascular site
What are catheter-associated urinary tract infections?
Bacterial contamination of catheter potentially leading to infections of urethra, bladder, ureters, or kidneys
Describe the burden of HAIs and how this has changed over time.
1 in 25 patients acquired an HAI prior to the COVID-19 pandemic
HAIs are extremely costly to treat
Over the past two decades, aggressive preventive action has been taken
Who is most at-risk for c. diff infections?
Older patients
Previous c. diff survivors
Those staying in the hospital for longer
Immunosuppressed
What percent of those ventilated contract pneumonia?
8-25%
How are central line infections prevented?
Disinfecting skin with 2% chlorhexidine prior to accessing port; disinfection of hubs, ports, and connection before/while accessing; hand hygiene; avoid femoral vein lines if possible; remove port when no longer needed
What are the symptoms of catheter-associated urinary tract infections?
Burning and pain in lower abdomen/when urinating, increased urination frequency, disseminated infections, various cognitive symptoms and poor appetite in elderly
Name three organizations/groups that track HAIs
CDC, states, National Healthcare Safety Network
What are symptoms of c. diff infection?
Abdominal pain
Diarrhea
Fever
Decreased appetite
Nausea
How is ventilator-associated pneumonia prevented?
How are central line infections treated?
Antibiotics––first immediately, then to match causative agent
What are various interventions to prevent HAIs?
Simple
- Hand hygiene
- Surface cleaning and disinfection
- Make sterile/sterilization equipment easy to access
- Infection prevention step checklists
More Complex
- Health worker training, audit, feedback
- Removing microbes from water and HVAC systems
- HAI and antibiotic resistance surveillance and reporting
1. C. diff
2. Ventilator-associated pneumonia
3. Catheter-associated urinary tract infections
4. Bloodstream infections due to MRSA
How is c. diff transmitted?
Fecal/oral
Spores on fomites
How is ventilator-associated pneumonia treated?
Antibiotics to match causative agent
What are catheter-associated urinary tract infections?
Bacterial contamination of catheter potentially leading to infections of urethra, bladder, ureters, or kidneys
What is antibiotic stewardship?
Program of policies and individual/group actions that promote appropriate antimicrobial drug use
What are risk factors for HAIs?
Patient characteristics:
Age (very old or young, premature birth)
Immunosuppression
Length of stay in hospital care/invasive procedures
Health care delivery factors:
Personnel shortages
Lapses in sanitation procedure
Use of home-based care
Antibiotic resistance
Bacterial colonization
How is c. diff treated?
What aspect of the immune system does ventilator-associated pneumonia block?
What are the symptoms of catheter-associated urinary tract infections?
Burning and pain in lower abdomen/when urinating, increased urination frequency, disseminated infections, various cognitive symptoms and poor appetite in elderly
Describe trends in vaccination among healthcare workers
Vaccination rates have increased over the past two decades, 79.9% received flu vaccine in 2021-22 and 87.3% completed primary COVID-19 vaccination