Hospital Infection Control and Antibiotic Prophylaxis

Hospital infection control measures may prevent a proportion of nosocomial infections. Handwashing plays a central role, reducing transmission of pathogens between individuals and from the hands of a given individual to vulnerable sites such as wounds and dialysis catheters. Perioperative antibiotic prophylaxis is also important in preventing surgical sepsis, together with good skin preparation before surgery and aseptic and surgical techniques. There is a wide range of other possible measures, implementation of which will be dictated by the global setting and healthcare infrastructure. Affluent nations can implement hospital infection control through an infection control team who devise policies, monitor hospital infections from a diagnostic microbiology laboratory or by active ward-based surveillance and implement outbreak procedures where necessary. An infection control manual containing policies detailing the approach to a wide range of issues from antibiotic use, to dealing with patients colonized or infected with MRSA, waste disposal and disinfection is usually produced. Medical staff are educated and actively encouraged to follow guidelines that reduce infection rates in given settings. For example, high-quality care of intravenous devices includes training of staff on line insertion and after care, the use of protocols and good mechanisms for recording line insertion and removal and infective complications. Hospital infection control in resource-poor areas of the world, where even the cheapest of antibiotics are barely affordable, is low on the priority list. The extent to which nosocomial infection occurs in such settings is little studied.

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