and other parts of the body.

Many types are difficult to

attack with antibiotics, and

antibiotic resistance is

spreading to Gram-negative

bacteria that can infect peo-

ple outside the hospital.

Epidemiology

Nosocomial infections are

commonly transmitted

when hospital officials be-

come complacent and per-

sonnel do not practice cor-

rect hygiene regularly.

Also, increased use of out-

patient treatment means that

people who are hospitalized

are more ill and have more

weakened immune systems

than may have been true in the past. Moreover,

some medical procedures bypass the body's natural

protective barriers. Since medical staff moves from

patient to patient, the staff themselves serves as a

means for spreading pathogens. Essentially, the staff

acts as vectors.

Categories and treatment

One-third of nosocomial infections are considered

preventable. The CDC estimates 2 million people in

the United States are infected annually by hospital-

acquired infections, resulting in 20,000 deaths. The

most common nosocomial infections are of the uri-

nary tract, surgical site and various pneumonias. Transmission

The drug-resistant Gram-negative germs for the

most part threaten only hospitalized patients whose

immune systems are weak. The germs can survive

for a long time on surfaces in the hospital and enter

the body through wounds, catheters, and ventilators.

Nosocomial infections are infections that are a

result of treatment in a hospital or a healthcare

service unit. Infections are considered nosoco-

mial if they first appear 48 hours or more after

hospital admission or within 30 days after dis-

charge. Nosocomial comes from the word

nosokomeio meaning hospital. This type of in-

fection is also known as a hospital-acquired

infection (or, in generic terms, healthcare-

associated infection). Besides harming patients

nosocomial infection can affect nurses, physi-

cians, custodians, aides, visitors, salespeople,

delivery personnel and anyone who has contact

with the hospital.

In the United States, the Centers for Disease

Control and Prevention estimate that roughly 1.7

million hospital-associated infections, from all

types of microorganisms, including bacteria,

combined, cause or contribute to 99,000 deaths

each year. In Europe, where hospital surveys

have been conducted, the category of Gram-

negative infections are estimated to account for

two-thirds of the 25,000 deaths each year. Noso-

comial infections can cause severe pneumonia

and infections of the urinary tract, bloodstream

Nosocomial Infection

Corygiene Watch V O L U M E 5 , S P E C I A L E D I T I O N

N E W S L E T T E R

D E C E M B E R 2 0 1 2

CORMART NIGERIA LIMITED Plot 14, Chivita Avenue, Ajao Estate, Lagos www.cormart-nigeria.com +234 1 7616605

Dear readers, Welcome to the fifth edi-tion of Corygiene Watch. In this special edition we have focused primarily on Cormart’s contribution to the Global Handwashing Day Celebration. We also featured an arti-cle, on the impact of healthcare associated infection, its prevention and control.

Isaac Martins isaac425@gmail.com

CORMART

C O R Y G I E N E W A T C H

In this edition Global Handwashing Day Celebration

Contributors: Oluwabunmi Ifejola E.P.I Afeonkai

P A G E 2

C O R Y G I E N E W A T C H

Risk factors

Factors predisposing a patient to infection can broadly be di-

vided into three areas:

People in hospitals are usually already in a poor state of

health, impairing their defense against bacteria – ad-

vanced age or premature birth along with immunodefi-

ciency (due to drugs, illness, or irradiation) present a gen-

eral risk, while other diseases can present specific risks -

for instance, chronic obstructive pulmonary disease can

increase chances of respiratory tract infection.

Invasive devices, for instance intubation tubes, catheters,

surgical drains, and tracheostomy tubes all bypass the

body‟s natural lines of defence against pathogens and

provide an easy route for infection. Patients already colo-

nised on admission are instantly put at greater risk when

they undergo an invasive procedure A patient‟s treatment itself can leave them vulnerable to

infection – immunosuppression and antacid treatment

undermine the body‟s defences, while antimicrobial ther-

apy (removing competitive flora and only leaving resis-

tant organisms) and recurrent blood transfusions have

also been identified as risk factors.

Prevention

Hospitals have sanitation protocols regarding uniforms, equip-

ment sterilization, washing, sanitizing, disinfecting and other

preventative measures. Thorough hand washing and/or use of

alcohol rubs by all medical personnel before and after each

patient contact is one of the most effective ways to combat

nosocomial infections. More careful use of antimicrobial

agents, such as antibiotics, is also considered vital.

Despite sanitation protocol, patients cannot be entirely iso-

lated from infectious agents. Furthermore, patients are often

prescribed antibiotics and other antimicrobial drugs to help

treat illness; this may increase the selection pressure for the

e m e r -

gence of

resistant

strains.

Isolation

Isolation

precau-

tions are

designed

to prevent

transmis-

sion of

microor-

ganisms

by com-

mon routes in hospitals. Because agent and host factors are

more difficult to control, interruption of transfer of microor-

ganisms is directed primarily at transmission.

Hand washing and gloving

Hand washing frequently is called the single most important

measure to reduce the risks of transmitting skin microorgan-

isms from one person to another or from one site to another on

the same patient. Washing hands as promptly and thoroughly

as possible between patient contacts and after contact with

blood, body fluids, secretions, excretions, and equipment or

articles contaminated by them is an important component of

infection control and isolation precautions.

Although hand washing may seem like a simple process, it is

often performed incorrectly. Healthcare settings must continu-

ously remind practitioners and visitors on the proper procedure

in washing their hands to comply with responsible hand wash-

ing.

All visitors must follow the same procedures as hospital staff to

adequately control the spread of infections. Moreover, mul-

tidrug-resistant infections can leave the hospital and become

part of the community flora if steps are not taken to stop this

transmission.

In addition to hand washing, gloves play an important role in

reducing the risks of transmission of microorganisms. Gloves

are worn for three important reasons in hospitals. First, gloves

are worn to provide a protective barrier and to prevent gross

contamination of the hands when touching blood, body fluids,

secretions, excretions, mucous membranes, and nonintact skin.

Wearing gloves does not replace the need for hand washing,

because gloves may have small, non-apparent defects or may

be torn during use, and hands can become contaminated during

removal of gloves. Failure to change gloves between patient

contacts is an infection control hazard.

Surface sanitation

Sanitizing surfaces is an often overlooked, yet crucial compo-

nent of breaking the cycle of infection in health care environ-

ments. Modern sanitizing methods such as NAV-CO2 have

been effective against gastroenteritis, MRSA, and influenza.

Use of hydrogen peroxide vapor has been clinically proven to

reduce infection rates and risk of acquisition. Hydrogen perox-

ide is effective against endospore-forming bacteria, such as

Clostridium difficile, where alcohol has been shown to be inef-

fective. A Bio-Intervention process is effective for hard surface

disinfection, providing a 6-log kill (99.9999%)for many organ-

isms including MRSA, VRE, Pseudomonas aeruginosa,

Staphylococcus aureus, Rhinovirus, Salmonella enterica,

H1N1, HIV-1 and Hepatitis A. The unique kill mechanism is

new to the market and will be an effective method against mu-

tation and resistance of organizations.

Aprons

Wearing an apron during patient care reduces the risk of infec-

tion. The apron should either be disposable or be used only

when caring for a specific patient.

Nosocomial Infection cont…..

Global Handwashing Day Celebration

Global Hand Washing day, which is observed

on October 15 of every year, when millions of

people around the world wash their hands

with soap and clean water, is one of such plat-

forms Renew Hand wash has leveraged on to

help raise hygiene-conscious generation.

In 2007, the Public Private Partnership for Hand washing with

Soap (PPPHW) established Global Hand washing Day as a

stimulating way to promote global and local vision of hand

washing with soap. Renew Handwash, one of the front liners

in the soap market in conjunction with UNICEF and Lagos

State ministry of water and rural development marked the

event in five riverine schools in Badagry area of Lagos state

where school children, teachers and community leaders were

put through the six steps of effective handwashing techniques.

Engineer Anibire who represented the honorable commis-

sioner for rural development disclosed that over 1000 public

and private schools had been touched in the last three years

and that the impact of the campaign has been positive because

it has drastically reduced germ-related ailment from feed

backs gotten from schools.

Speaking on the 2012 campaign, Chris Olusesi of Cormart

said the involvement of Renew handwash underlined the com-

mitment of the company to create hygiene conscious society.

Why Celebrate Hand washing?

6.9 million Children under 5 die each year. Two of the top

three causes are pneumonia and diarrhea.

Hand washing with soap can cut pneumonia by up to 45% and

diarrhea rates by up to 50%.

Hand washing is an accessible, cost-effective method for pre-

venting diarrheal and other diseases.

A recent study also shows that intensive hand washing promo-

tion is positively associated with child growth and develop-

ment.

Photo Gallery

Pictures Clockwise: Chris Olusesi of cormart demonstrating handwash - Engr Anibire

representing the commissioner for Rural Development, washing her hands - school

children waiting to wash their hands - Pupils washing their hands

Hand washing Challenges

Difficult to change behavior on a large scale

Each critical time for hand washing has different target

users, motivators, prompts, and hardware needs

What does it take to change hand washing social norms?

JOKE

A man was upset because he had lost his favorite hat. Instead of buying a new one, he decided that he would go to church that

Sunday to steal one from the vestibule. Unfortunately, the usher saw the man coming in and before he could go into the vesti-

bule, the usher led him to a pew, where the preacher was just beginning a sermon on the Ten Commandments. After church, the

man went up to the preacher and shook his hand and said: „I want to thank you for saving my soul today. I came to church to

steal a hat, but after hearing your sermon on the Ten Commandments, I changed my mind.‟ „Why, that‟s wonderful,‟ the

preacher said: „so the commandment „Thou shalt not steal” changed your mind, did it?” ” No, it wasn‟t that commandment,” the

man said: “It was the one about adultery. It reminded me where I left my hat!”

C O R Y G I E N E W A T C H

P A G E 3