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HAI - Hospital Acquired Infections

Hospital-acquired infections also known as healthcare-associated infections or nosocomial infections that are typically not present or incubating at the time of admission. These are newly acquired infections that are contracted within a hospital environment.

As medical care becoming more complex and antibiotic resistance is increasing, the cases of HAIs are growing. The good news is that HAIs can be prevented in a lot of healthcare situations.

Anyone admitted to a healthcare facility is at risk for contracting a HAI.

The most common type of HAI's are:

Urinary tract infections (UTIs)
Surgical site infections
Gastroenteritis
Meningitis
Pneumonia

Anyone admitted to a healthcare facility is at risk for contracting a HAI. Your risk also increases if you’re admitted to the ICU. The chance of contracting a HAI in pediatric ICUs is 6.1 to 29.6 percent. A study has found that nearly 11 percent of roughly 300 people who underwent operations contracted a HAI. Contaminated areas can increase your risk for HAIs by almost 10 percent.

HAIs are also more common in developing countries. Studies show that five to 10 percent of hospitalizations in Europe and North America result in HAIs. In areas such as Latin America, Sub-Saharan Africa, and Asia, it’s more than 40 percent.

Main Routes Of Transmission With Description

Contact Transmission

The most important and frequent mode of transmission of nosocomial infections is by direct contact.

Droplet Transmission

Transmission occurs when droplets containing microbes from the infected person are propelled a short distance through the air and deposited on the patient's body; droplets are generated from the source person mainly by coughing, sneezing, and talking, and during the performance of certain procedures, such as bronchoscopy.

Airborne Transmission

Dissemination can be either airborne droplet nuclei (small-particle residue {5 µm or smaller in size} of evaporated droplets containing microorganisms that remain suspended in the air for long periods of time) or dust particles containing the infectious agent. Microorganisms carried in this manner can be dispersed widely by air currents and may become inhaled by a susceptible host within the same room or over a longer distance from the source patient, depending on environmental factors; therefore, special air-handling and ventilation are required to prevent airborne transmission. Microorganisms transmitted by airborne transmission include Legionella, Mycobacterium tuberculosis and the rubeola and varicella viruses.

Common Vehicle Transmission

This applies to microorganisms transmitted to the host by contaminated items, such as food, water, medications, devices, and equipment.

Vector Borne Transmission

This occurs when vectors such as mosquitoes, flies, rats, and other vermin transmit microorganisms.

Airborne HAI’s:

While contact transmission of disease forms the majority of HAI cases, transmission through the air is harder to control, but one where the engineering sciences can play an important role in limiting the spread. HAI’s have proven to be a persistent and sometimes tragic problem. If transmission by direct contact predominates, as many experts suggest, then surface-disinfection technologies should have a major impact in reducing infection rates.

But with more than a third of all nosocomial infections involving airborne transmission at some point, the combination of surface and air disinfection should produce optimum results. Air-contaminant control often is accomplished with high rates of room air exchange using filtered 100- percent outside air.

Tuberculosis (TB; Mycobacterium tuberculosis) is clearly transmitted in the air and can be a source of outbreak in hospitals. Healthcare workers infected with TB can spread the infection widely and extensive screening of patients and other staff may be necessary. Similarly, Norovirus is transmitted by aerosol and is difficult to contain in a hospital ward without sufficient single rooms with en suite toilets. Historically, natural ventilation was seen to be beneficial in hospital wards and was part of hospital design. With the advent of sealed high-rise buildings and forced ventilation, expensive negative pressure rooms have been introduced to house patients with infections thought likely to be transmitted by aerosol. The spread of tuberculosis among HIV patients was a recent dramatic example of the problems with enclosed rooms and prisons. To ensure sufficient dilution of the bacterial load around an infected patient, room air should be changed several times every hour.

Hospital workers, as well as patients, are at risk of nosocomial infections, with worker fatalities reported

Airborne nosocomial infections are transmitted directly or indirect ly through air and may cause respiratory (primarily pneumonia) and surgical-site infections. The degree to which the transmission of nosocomial infections is airborne is unknown. One source estimate that 10 percent of nosocomial infections are airborne, while another states that 16 percent of ICU infections result from airborne-pathogen transmission.

Hospital workers, as well as patients, are at risk of nosocomial infections, with worker fatalities reported. Health-care professionals routinely are exposed to contagious respiratory infections such as TB and influenza. In most cases in which medical workers have contracted respiratory infections from inhalation, the root cause has been inadequate local ventilation, malfunctioning systems and equipment, or administrative-control problems.

How to Control Hospital Acquired Infections:

The control strategies for infection control, that reflect the transmission pathways & are generally divided into three categories: personal measures, administrative controls and engineering controls. Personal measures and administrative controls are necessarily intertwined as the former cannot be controlled without the latter. Personal measures are instructed to patients, visitors and clinical staff and can include a variety of measures, including hand washing (even for airborne diseases), the wearing of masks, removal of jewellery (and ‘bare below the elbow’), reduced physical contact (such as kissing, etc.).

Engineering control methods include building ventilation, use of HEPA and other air cleaning methods, use of air disinfection methods, etc. Ventilation refers to the supply of outdoor air into a building or a room, and its distribution within it. The general purpose of ventilation in buildings is to provide healthy air for breathing by both diluting the pollutants originating in the building and removing the pollutants from it.

The effectiveness of ventilation is also known for controlling airborne diseases in single enclosed spaces. There are two basic physical principles behind the roles of ventilation in infection control. The first is, through dilution of airborne pathogens, and the second is, the control of movement of airborne pathogens from one space to another.

To reduce the spread of any infectious disease, the route of transmission needs to be known.

Airborne infection control provides a number of challenging questions to the building ventilation community, and most of these questions need input from multiple disciplines:

How are pathogen-laden droplets released, dispersed and evaporated in the room air?
How do such dispersions interact with the room air flow, body air flow and inhalation/exhalation flows?
What are the most effective ventilation methods for homes and offices?
What are the roles of simple ventilation methods in resource-limited settings?
Is it possible to develop more effective and advanced ventilation methods?
How the ventilation requirement for infection control differ from that for comfort and general health?

Among these questions, the most basic should be what the ventilation requirements are for airborne infection control and what personal measures should be collectively applied to remediate transmission. We, at Sterlomaxx are continually working on better ways & technologies to control the spread of airborne infections in a closed environment. We strive towards achieving improved indoor air quality in the healthcare facilities. As we firmly believe prevention in the key.

Reduce Hospital Acquired Infections