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Infection Control & Related Microbiology DAHS 1010, DAHS 2010. Healthcare Associated Infection Beverley Gallacher. Hospital Acquired (Nosocomial) Infections. One that is neither present or incubating at the time when a patient is admitted to hospital
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Infection Control & Related Microbiology DAHS 1010, DAHS 2010 Healthcare Associated Infection Beverley Gallacher
Hospital Acquired (Nosocomial) Infections • One that is neither present or incubating at the time when a patient is admitted to hospital • If patients acquire an infection more than 72 hours after admission it is considered to be hospital acquired rather than community acquired
The Scale of the Problem • “At any given time, some 9% of patients in hospital have a HAI” (NAO report 2000) • Based on a survey of 37,111 patients in 15 centres, from May 1993 to July 1994 Emmerson et al (1996) in NAO report (2000)
Most Common Types of HAI 6.2% 23.2% • Blood (septicaemia) • Urinary tract • Surgical wound • Lower respiratory tract • Skin 72.6% approx 10.7% 22.9% 9.6% • “Other” - specific infectious diseases; influenza, viral gastroenteritis, & in rare cases legionnella & tuberculosis etc.
Estimated Costs to the N.H.S. (NAO Report 2000) • £1 billion / year • Based on extrapolation of results from one hospital to the rest of the NHS • “Attributing costs to hospital acquired infection is complex and uncertain” • Why? • Many factors involved in costs. Estimate how many extra days inpatient stay resulted from the HAI
Estimated “Human” Costs to the NHS Longer inpatient stay Death Permanent disability Discomfort Extrapolate U.S.data - 1% all deaths primarily due to HAI Difficult to estimate, no UK data available
Prevention & Treatment of HAI’s • Estimated that 30% of HAI’s are preventable. • Why not 100%? • How are they preventable? “By putting infection control and basic hygiene at the heart of good management & clinical practice” Antibiotics - resistant strains
Hospital Acquired Infection HAI Healthcare Associated Infection
References • The Management and control of Hospital Acquired Infection in Acute NHS Trusts in England. (2000) National Audit Office. London HMSO • Kelly J & Chivers G (1996) Built in Resistance. Nursing Times 92. 2. 50-54 • Duckworth G (1993) Diagnosis & management of MRSA infection. B.M.J. 307. 1049-52