* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
Download Infection control in Healthcare Setting
Survey
Document related concepts
Hepatitis B wikipedia , lookup
Schistosomiasis wikipedia , lookup
Gastroenteritis wikipedia , lookup
Staphylococcus aureus wikipedia , lookup
Marburg virus disease wikipedia , lookup
Sexually transmitted infection wikipedia , lookup
Human cytomegalovirus wikipedia , lookup
Dirofilaria immitis wikipedia , lookup
Oesophagostomum wikipedia , lookup
Carbapenem-resistant enterobacteriaceae wikipedia , lookup
Anaerobic infection wikipedia , lookup
Neonatal infection wikipedia , lookup
Transcript
به نام خدا [email protected] 5/23/2017 1 Role of Microbiology laboratory In Prevention of Healthcare-associated infections Sina Mobasherizadeh PhD Candidate of Bacteriology IUMS Healthcare-associated infections, or HAIs, are infections that people acquire while they are receiving treatment for another condition in a healthcare setting. HAIs can be acquired anywhere healthcare is delivered, including: inpatient acute care hospitals, outpatient settings such as ambulatory surgical centers and end-stage renal disease facilities, and long-term care facilities such as nursing homes and rehabilitation centers. HAIs may be caused by any infectious agent, including bacteria, fungi, and viruses, as well as other less common types of pathogens. [email protected] 5/23/2017 3 [email protected] 5/23/2017 4 These infections are associated with a variety of risk factors, including: Use of indwelling medical devices such as: bloodstream, endotracheal, and urinary catheters. Surgical procedures, Injections, • Contamination of the healthcare environment Transmission of communicable diseases between patients and healthcare workers Overuse or improper use of antibiotics. [email protected] 5/23/2017 5 importance of the Problem HAIs are a significant cause of morbidity and mortality. At any given time, about 1 in every 20 inpatients has an infection related to hospital care. These infections cost the U.S. healthcare system billions of dollars Each year and lead to the loss of tens of thousands of lives. In addition, HAIs can have devastating emotional, financial and medical consequences. [email protected] 5/23/2017 6 Transmission of Nosocomial Infections Healthcare worker to patient [email protected] Patient to healthcare worker Patient to patient 5/23/2017 7 A majority of hospital-acquired HAIs include: Urinary tract infections Surgical site infections Bloodstream infections Pneumonia [email protected] 5/23/2017 8 [email protected] 5/23/2017 9 Microbiologist as Member of Infection Control Committee (ICC), Infection Control Team (ICT) and Antibiotic Committee Role of Laboratories “Provide information for decision making [email protected] 5/23/2017 10 Having microbiology laboratory as a part of the hospital diagnostic laboratories, is a huge advantage for HAI prevention and control. Microbiology laboratory has two main functions in the hospital: one is diagnosis of infection in individual patient, directly related to the patient care and the other is support to the HAI prevention and control. [email protected] 5/23/2017 11 The role in HAI prevention O 1. Rapid Communication [email protected] 5/23/2017 12 [email protected] 5/23/2017 13 2. Accurate speciation and typing of isolated pathogen To be useful for epidemiological studies of HAI, isolated bacterial strains should be identified to the species level. There are two groups of typing methods: a) phenotyping b) genotyping [email protected] 5/23/2017 14 3. Participation in outbreak management The early isolation of a new or unusual microorganism enables the ICP to take appropriate measures to stop it from spreading at the very beginning. Laboratory staff may also report clustering of infections (two related isolates in different patients in the same time frame), which then enables ICP to go and check these cases. [email protected] 5/23/2017 15 4. Participation in HAI surveillance Surveillance of HAI is an important task of a well organized infection control. in alert or multi-drug resistant (MDR) organisms surveillance the role of microbiology laboratory is crucial. The most important ‘alert’ microorganisms are: [email protected] 5/23/2017 16 •Methicillin-resistant Staphylococcus aureus (MRSA) • Vancomycin-intermediate S. aureus (VISA) • Vancomycin-resistant enterococci (VRE) • MDR Pseudomonas aeruginosa • MDR Acinetobacter baumannii • MDR Mycobacterium tuberculosis • ESBL enterobacteria • Clostridium difficile [email protected] 5/23/2017 17 C. difficile infections are at an all-time high C. difficile infections are linked to 14,000 deaths in the US each year. O Deaths related to C. difficile increased 400% between 2000 and 2007, due in part to a stronger germ strain. O Most C. difficile infections are connected with receiving medical care. O Almost half of infections occur in people younger than 65, but more than 90% of deaths occur in people 65 and older. O Infection risk generally increases with age; children are at lower risk. O C. difficile germs move with patients from one health care facility to another, infecting other patients. [email protected] 5/23/2017 18 [email protected] 5/23/2017 19 [email protected] 5/23/2017 20 [email protected] 5/23/2017 21 5. Participation in resistance surveillance The surveillance of bacterial resistance to antimicrobial agents is very important task of microbiological laboratory. [email protected] 5/23/2017 22 Antimicrobial Resistance Surveillance is dependent on all of the following: O Obtaining appropriate specimens from the infected individual O Successful isolation of the causative organisms O Accurate determination of antimicrobial resistance O Data collection, collation and analysis O Dissemination of appropriate information for Action [email protected] 5/23/2017 23 WHONET 5 Software [email protected] 5/23/2017 24 WHONET is a free software developed by the WHO Collaborating Centre for Surveillance of Antimicrobial Resistance for laboratorybased surveillance of infectious diseases and antimicrobial resistance. The principal goals of the software are: • to enhance local use of laboratory data; and • to promote national and international collaboration through the exchange of data. [email protected] 5/23/2017 25 [email protected] 5/23/2017 26 [email protected] 5/23/2017 27 6. Education of HAI prevention personnel and other healthcare workers Microbiologist acts also as an educator for infection control personnel, first about characteristics of microorganisms that are important for epidemiology of infections, Then about normal flora, difference between contamination, colonization and infection with specific organisms, furthermore about interpretation of microbiological reports and charts. [email protected] 5/23/2017 28 Hand disinfection Samples taken from hands a) ccontaminated hands [email protected] b) after washing hands Quelle: Händehygiene in der Medizin, 1996 c) after hand disinfection 5/23/2017 29 [email protected] 5/23/2017 30