Updated: 6/14/2019

Infection Prevention

Review Topic
  • Introduction
    • there is a high risk of transmission of pathogens causing infections in the healthcare setting
    • techniques to prevent health-care associated infection in patients, healthcare providers, and other hospital staff
      • standard precautions
        • hand hygiene
        • personal protective equipment (PPE)
        • respiratory hygiene etiquette
        • safe injection and sharps practices
      • disinfection/cleaning
      • sterilization of hospital equipment
      • isolation precautions
    • key terms
      • sterilization
        • to kill or eliminate all pathogens
        • e.g., autoclave process
      • disinfection
        • to eliminate or neutralize pathogens to reduce possible contamination to a safe level
        • e.g., hand washing
Standard Precautions
  • Hand hygiene
    • handwashing with soap and water
      • more dehydrating with repeated use
      • drying with paper towels reduces the total number of bacteria on hands
    • disinfecting agents (often alcohol-based)
      • risk of contact dermatitis and irritation
    • artificial nails should not be present
  • PPE
    • should be worn when hospital staff are exposed to any body secretions
      • gloves
      • masks
      • safety glasses/face shield
      • gowns
  • Respiratory hygiene etiquette
    • covering nose and mouth while coughing
    • hand hygiene after contact with any respiratory secretions
    • using mask as needed
  • Safe injection and sharps practices
    • prompt and safe disposal of sharps
  • Skin or mucous membranes
    • alcohol
      • prior to puncturing the skin with a needle
      • dissolves lipid bilayer membranes and denatures proteins
      • ineffective against protozoan oocysts, some nonenveloped non-lipophilic viruses, and bacterial spores
    • chlorhexidine
      • disinfection of hands prior to surgery
      • prep a body area for a procedure
      • wound cleaning
    • iodine
      • wound cleaning or prevention of infection
  • Surfaces
    • aldehydes, halogens, hydrogen peroxide, and halogens
      • denatures cell components
      • effective against spores and all viruses
  • Sterilization techniques are used to kill or eliminate all pathogens, including its spores, on equipment, e.g., surgical instruments that come into contact with sterile body parts or fluids
  • Autoclave
    • direct high-pressure steam at > 121°C
      • denatures enzymes and proteins in pathogens
    • not effective against prions
      • prions must be sterilized at higher temperatures for longer periods of time
    • most commonly used
  • Dry heat or “oven” sterilization
    • temperatures of 150-170°C
      • denatures and oxidizes cell parts
    • used only on instruments made of metal or glass
  • Chemical sterilizing agents
    • aka “cold sterilization”
      • ethylene oxide gas
        • alkylation of proteins and genetic material
        • spores may resist this process
      • hydrogen peroxide gas plasma
        • free radical damage to cell parts
    • used when autoclave and dry heat cannot be used for heat- and moisture-sensitive instruments
  • Radiation
    • not commonly used
Isolation Precautions
  • Contact precautions
    • for patients with multi-drug resident (MDR) pathogens
    • gowns and gloves for all hospital staff
    • medical equipment should be dedicated to the single patient
  • Droplet precautions
    • droplets: respiratory secretions ≥ 5 microns
    • surgical mask
  • Airborne precautions
    • airborne droplet nuclei: respiratory secretions < 5 microns
    • respirator mask with 95% filtering capacity
      • requires a fit testing to ensure tight seal over nose and mouth

Pathogens with Specific Isolation Precautions
Contact Precautions
Droplet Precautions
Airborne Precautions
  • MDR bacteria
    • MRSA
    • VRE
  • Enteric infections
    • norovirus
    • E. coli
  • Viruses
    • VZV
    • HSV
    • RSV
    • parainfluenza
    • enterovirus
    • rhinovirus
  • Scabies
  • Skin and soft tissue infections
    • S. aureus
    • group A streptococcus
  • Bacteria
    • Neisseria meningitides
    • Mycoplasma pneumoniae
    • Haemophilus influenzae type B
    • Bordetella pertussis
    • group A streptococcus
    • Diphtheria
  • Viruses
    • influenza
    • rubella
    • mumps
    • adenovirus
    • rhinovirus
    • parvovirus B19
  • Tuberculosis
  • VZV
  • Measles
  • Smallpox
  • SARS
  • Ebola virus


Please rate topic.

Average 5.0 of 4 Ratings

Thank you for rating! Please vote below and help us build the most advanced adaptive learning platform in medicine

The complexity of this topic is appropriate for?
How important is this topic for board examinations?
How important is this topic for clinical practice?
Topic COMMENTS (4)
Private Note