Infection Control
"Infection Control" refers to the policies, procedures, and practices implemented in healthcare settings and other environments to prevent or stop the spread of infections. The overarching goal is to protect patients, healthcare workers, and visitors from harm caused by avoidable infections, reduce healthcare-associated infections (HAIs), and combat antimicrobial resistance.
Purpose of Infection Control Programs
The main purposes of robust infection control programs are:
Preventing Transmission
To break the chain of infection, stopping microorganisms from spreading from one person or surface to another.
Reducing Healthcare-Associated Infections (HAIs)
Minimizing infections acquired by patients during their stay in a healthcare facility. HAIs can lead to increased morbidity, mortality, prolonged hospital stays, and higher healthcare costs.
Combating Antimicrobial Resistance (AMR)
By preventing infections, the need for antibiotics is reduced, thereby slowing the development and spread of drug-resistant microorganisms.
Protecting Healthcare Workers
Safeguarding staff from occupational exposure to infectious agents.
Ensuring Patient Safety and Quality of Care
A fundamental aspect of providing safe and high-quality healthcare.
Responding to Outbreaks
Having established protocols to quickly identify, contain, and manage outbreaks of infectious diseases.
Key Principles and Components of Infection Control Practices
Infection control practices are built upon a foundation of core principles
Hand Hygiene
- Description: The single most important measure to prevent the spread of infections. Involves thorough hand washing with soap and water or using alcohol-based hand rubs.
- Practice: Performed before and after patient contact, before aseptic procedures, after body fluid exposure, and after touching patient surroundings.
Personal Protective Equipment (PPE)
- Description: Barriers used to protect healthcare workers from exposure to infectious agents (e.g., gloves, gowns, masks, eye protection).
- Practice: Selection and use of PPE depend on the anticipated exposure to blood, body fluids, secretions, and excretions. Proper donning and doffing (putting on and taking off) procedures are crucial.
Environmental Cleaning and Disinfection
- Description: Regular and thorough cleaning and disinfection of patient care areas, surfaces, and equipment.
- Practice: Use of appropriate disinfectants, adherence to cleaning schedules, and proper handling of contaminated items.
Safe Injection Practices
- Description: Practices to prevent transmission of infectious diseases during parenteral medication administration.
- Practice: Using a new sterile needle and syringe for each injection, preventing contamination of injectable medications, and proper disposal of sharps in puncture-resistant containers.
Waste Management
- Description: Proper segregation, handling, and disposal of medical waste to prevent exposure and environmental contamination.
Education and Training
- Description: Continuous education for all healthcare personnel on infection prevention principles and practices.
- Practice: Regular training sessions, competency assessments, and providing up-to-date guidelines.
Standard Precautions
- Description: A set of infection control practices used for all patient care, regardless of suspected or confirmed infection status. They are based on the principle that all blood, body fluids, non-intact skin, and mucous membranes may contain transmissible infectious agents.
- Components: Includes hand hygiene, use of PPE, safe injection practices, safe management of contaminated equipment, respiratory hygiene/cough etiquette, and appropriate patient placement.
Transmission-Based Precautions
- Description: Additional precautions used in addition to Standard Precautions for patients with known or suspected infections that can be transmitted by specific routes.
- Types:
- Contact Precautions: For infections spread by direct or indirect contact (e.g., difficile, MRSA). Requires gloves and gowns.
- Droplet Precautions: For infections spread by large droplets expelled during coughing, sneezing, or talking (e.g., influenza, pertussis). Requires a surgical mask.
- Airborne Precautions: For infections spread by small airborne particles that remain suspended in the air (e.g., tuberculosis, measles, chickenpox). Requires a special fitted respirator (N95 mask) and an Airborne Infection Isolation Room (AIIR) with negative pressure.
Sterilization and Disinfection of Medical Equipment
- Description: Processes to render medical devices free of viable microorganisms (sterilization) or reduce the number of microorganisms (disinfection).
- Practice: Strict adherence to protocols for reprocessing reusable medical instruments.
Surveillance and Monitoring
- Description: Ongoing collection, analysis, and interpretation of data on infection rates and trends (e.g., HAIs, antimicrobial resistance patterns).
- Practice: Using data to identify problem areas, evaluate the effectiveness of interventions, and detect outbreaks early.
Role of the Diagnostic Laboratory in Infection Control
The diagnostic laboratory, particularly the clinical microbiology lab, is an indispensable partner in infection control efforts. Its contributions are multifaceted:
Rapid and Accurate Pathogen Identification
- Contribution: Quickly identifies the specific bacteria, viruses, fungi, or parasites causing an infection.
- Impact on Control: Knowing the pathogen allows for the implementation of appropriate transmission-based precautions (e.g., contact, droplet, airborne isolation) and targeted treatment, preventing further spread.
Antimicrobial Susceptibility Testing (AST)
- Contribution: Determines which antibiotics are effective against isolated bacterial pathogens.
- Impact on Control: Guides clinicians in selecting the most effective and narrow-spectrum antibiotic, reducing the use of broad-spectrum antibiotics that drive antimicrobial resistance. This is a cornerstone of Antimicrobial Stewardship, a key part of infection control.
Surveillance and Trend Monitoring
- Contribution: Collects and analyzes data on the types of pathogens circulating in the healthcare setting, their resistance patterns, and infection rates.
- Impact on Control: Acts as an “early warning system” for emerging resistance (e.g., MRSA, VRE, carbapenem-resistant organisms) or unusual clusters of infections, alerting infection control teams to potential outbreaks.
Outbreak Investigation
- Contribution: Provides molecular “fingerprinting” (e.g., pulsed-field gel electrophoresis, whole-genome sequencing) of isolates to determine if infections are linked to a common source or if a specific strain is spreading.
- Impact on Control: Helps to confirm outbreaks, identify the source of transmission, and guide interventions to contain the spread.
Quality Control of Specimen Collection
- Contribution: Monitors specimen quality (e.g., contamination rates in urine cultures, appropriateness of respiratory samples).
- Impact on Control: Works with clinical staff to improve collection techniques, reducing misdiagnosis and unnecessary antibiotic use due to contaminated samples.
Advisory and Educational Role
- Contribution: Microbiologists and laboratory professionals serve as consultants to infection control committees, providing expertise on pathogen characteristics, diagnostic limitations, and resistance mechanisms.
- Impact on Control: Educates healthcare staff on proper specimen collection, interpretation of lab results, and the implications of resistance patterns.