ICU Infection

Question.

215. In post-operative intensive care unit, five patients developed post-operative wound infection on the same day. The best method to prevent cross infection occurring in other patients in the same ward is to:

1. Give antibiotics to all other patients in the ward.

2. Fumigate the ward.

3. Disinfect the ward with sodium hypo chlorite.

4. Practice proper hand washing.

Answer

4. Practice proper hand washing.

Reference

Katzung 7^th Edition Pg-805,

Nelson Chapter-174

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Discussion

Strict attention to hand washing techniques is the most effective measure for preventing the spread of staphylococci from one individual to another

Transmission of S. aureus generally occurs by direct contact or by spread of heavy particles over a distance of 6 ft or less. Spread by fomites is rare. Heavily colonized individuals and perianal carriers are particularly effective disseminators. Neonates are extremely susceptible to staphylococci; the nasopharynx, skin, perineum, and umbilical stump are the most common sites of colonization. Autoinfection is common, and minor infection (e.g., styes, pustules, paronychia) may be the source of disseminations. Handwashing between contacts with patients decreases the spread of staphylococci from patient to patient. Older children and adults are more resistant than the neonate to colonization.

PREVENTION. Staphylococcal infection is transmitted primarily by direct contact. Strict attention to handwashing techniques is the most effective measure for preventing the spread of staphylococci from one individual to another . Use of a detergent containing an iodophor, chlorhexidine, or hexachlorophene is recommended. In hospitals or other institutional settings, all persons with acute staphylococcal infections should be isolated until they have been treated adequately. There should be constant surveillance for nosocomial staphylococcal infections within hospitals. Infectious disease control measures may reduce the spread of infection

Explanation

1. Give antibiotics to all other patients in the ward is not the best method.

2. Fumigate the ward is a far fetched option.

3. Disinfect the ward with sodium hypochlorite – Asking for too much.

4. Practice proper hand washing is the best option.

Comments

A Micro Question from Pharmac / Nelson as well as many surgery books

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