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Hospital hygiene
Kolářová M., Spring 2016
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Chain of Infection
Causative agent - bacteria, viruses,
fungi, parasites, priony
Source of infection
The ende incubation period,, illness
carriers
Mode of transmission
-direct
-indirect
Susceptible
host Infection
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Chain of Infection in Hospital Conditions
Source
of Infection
The Transmission Susceptibility
pacient pacient
pacient Health worker
Health worker pacient
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EPIDEMIC PROCESS IN THE HOSPITAL ENVIRONMENT
SOURCES
OF INFECTION
MODE
OF TRANSMISSION
trough
biological material
of patients
or contaminated surfaces
or equipments
SUSCEPTIBLE
HOST
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Biological materials – their infectivity
1. Causative agens in blood, derivates from blood, plasma
VHB, VHC, VHA (short in the blood), HIV, CMV, rarely EBV,
virus of morbilli (viremie), kandidy-kandidémie,
malárie - (plasmodia can survive in fresh plasma 3 – 5oC - 14
days),
Toxoplasma gondii - (can survive in blood - 56 days)
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Biological materials – their infectivity
2. Causative agens in droplets
Adenovirus, coronaviruses, enteroviruses, herpes virus,
myxovirus (influenzae), paramyxovirus, RSV, rhinovirus,
Stafylococcus, Streptococcus spp., Meningococcus spp.,
Haemophilus Influenzae, Neisseria meningitis, Bordetella
pertussis, Bordetella parapertussis, Mycoplasma pneumoniae,
Pneumocystis carinii, Kandidy….
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Biological materials – their infectivity
3. Causative agents in stool
Enteroviry (VHA, poliomyelitis), VHE, coxsackie viry,
Adenoviry,
Enterobactericeae (E.coli, Klebsiella pneumoniae,
Pseudomonas aeruginosa, Proteus spp., Citrobacter,
Enterobacter, Serratia apod)
Listeria monocytogenes, Clostridium perfringens, Clostridium
tetani, Pneumocystis carinii
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Biological materials – their infectivity
Causative agens in:
4. URINE
Virus of measles, parotitis, CMV, VHB, papovavirus, Listeria
monocytogenes, Candidae
5. LIQUOR
HIV, different causative agents of meningitid
6. Salive
VHB, HIV, CMV, EBV, herpes virus hominis typ 1,2, virus
of measles, rubellla
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Biological materials – their infectivity
7. TEARS, EYE - SECRET
VHB, HIV, adenoviruses, Enterovirus typ 70, Coxsackie A 24,
Staphylococcus aureus, hemophfilus, pneumokoky, moraxely,
chlamydie
8. VAGINA AND CERVIX - SECRET
HIV, VHB, rare VHC, herpes virus hominis typ 1,2,
Streptococcus agalactiae, Neisseria gonorrhoea, Haemophilus
Ducreyi, Treponema pallidum, Trichomonas vaginalis,
Chlamydia lymfogranulomatosis, Chlamydia trachomatis
9. EJACULAT
VHB, HIV, rare VHC, CMV,
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Chain of Infection in Hospital Conditions
SOURCE
OF INFECTION
MODE
OF TRANSMISSION
SUSCEPTIBLE
ORGANISM
HANDWASHING, DISINFECTION OF HANDS
LINEN WASING,
CLEANING
……..,
………
DISINFECTION
STERILIZATION
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Construction,
technical
conditions
Mikroclimate
Laundry
Food,
water
Bathroom,
WC
Cleaning,
transport
Specific
entrance
-medical devices
Emision
Liquid
waste
Chemical
waste
Radioactive
waste
Komunální
odpady
Medical waste
incl.sharp
Care for a patients
People
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PACIENT
LINEN WASHING,
………..,
DISINFECTION,
STERILIZATION
Wastes
A) Tools for one use
B) Reuseable tools
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Staphylococcus aureus in a patient who has a Hickman catheter. The extending cellulitis
(maximum extent shown by black marker pen line) has responded but the local tunnel infection
persists and mandates line removal.
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Catheter exit site infection in a patient with central venous catheterization through the jugular vein.
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Diffuse skin involvement with petechial lesions in a patient with
Staphylococcus aureus bacteremia, endocarditis and acute aortic
insufficiency.
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An acutely infected knee replacement. The site was washed out but the
infection failed to resolve. At re-operation the implant was found to be
loose and it needed to be removed. Staphylococcus aureus was grown
from deep specimens.
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Municipial waste – syringes with blood !!!
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Municipial waste – test tubes with blood !!!
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Municipial waste – ………. !!!
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Sorted waste – glasses with syringes and needles (after using) !!!!
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Sorted waste – glasses with giving set (after using) !!!!
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The rest medicaments in the glasses = hazardous waste !!!
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The bag with blood in the transparent sack !!!! (must be black and
nontransparent and fat (0,2 mm) with symbol „Biological Risk)