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CORPUZ, KRISTINE CASANDRA Y.

Principles of Infection; Prevention and Control

a) Chain of Infection
b) Current Global trends and statistics of infection
Kristine Casandra Y. Corpuz
Union Christian College
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 Infection prevention and control (IPC) is a scientific approach and practical solution
designed to prevent harm caused by infection to patients and health workers. It is
grounded in infectious diseases, epidemiology, social science and health system
strengthening.
 Infection prevention and control is the application of microbiology in clinical practice.
Infection can be caused by bacteria, fungi, viruses, or prions and can affect almost all
body systems.

The Five basic principles of infection control:

1. Using personal protective equipment (PPE) - is one of the best ways to stop infections
from spreading. It blocks anything from coming out of the ‘portal of exit’ and potentially
causing an infection in another person. This is just one part of the chain of infection.
Numerous types of PPE:
 Aprons  Gloves
 Masks  Hair nets
As a result you need to learn how to properly “put it on, use it, remove it and dispose of it”.

2. Disinfecting surfaces and equipment – another very important principle for controlling
infection is disinfecting all the surfaces and equipment after use. This is because there could
be blood, bodily fluids or other harmful substances on them that could cause an infection. By
sanitising surfaces and tools, you prevent the “transmission” stage in the chain of infection.

3. Good personal hygiene- is essential for preventing the spread of infection. The most
important to do is wash your hands regularly. You need to properly wash your hands before
and after work activities, as well as eating or drinking.

4. Careful wound care- try and protect any “portal of entry” as much as possible. To do this,
use antiseptic wipes to prevent bacteria from entering an open wound at all costs. Cuts are
one of the most common injuries, and it’s important to be careful even with the smallest cuts.

5. Treating underlying diseases. – treating underlying diseases and knowing if you have a
high-risk patient helps hugely in combating healthcare associated infections (HCAI’S). These
are “infectious that develop in a patient, as a direct result of receiving healthcare”. Its
important to treat the underlying issue as quickly as possible, to prevent infections from
spreading further.

A. Chain of Infection
Certain conditions must be met in order for a microbe or infectious disease to be spread from
person to person. This process, called the chain of infection, can only occur when all six links
in the chain are intact. By breaking this chain at any of the links, the spread of infection is
stopped.
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• Disease Microorganisms (Agent). These are the pathogens that cause communicable
diseases. Most commonly these are bacteria, virus, fungi or parasites.

• Reservoir. The reservoir (source) is a host which allows the pathogen to live, and possibly
grow, and multiply. Humans, animals and the environment can all be reservoirs for
microorganisms. Sometimes a person may have a disease but is not symptomatic or ill. This
type of person is a carrier and she/he may be referred to as ‘colonized’. Examples of
reservoirs are standing water, a person with a common cold or syphilis, or a dog with rabies.

• Mode of Escape. This refers to the route by which the infectious microorganisms escape or
leave the reservoir. For example, pathogens that cause respiratory diseases usually escape
through the respiratory tract (coughing and sneezing).

Modes of Escape Breaking the Link

Respiratory Tract. Microorganisms leave
the body of the infected person by means of
droplets exhaled as a spray when coughing,
sneezing, talking, singing or just breathing.
Microorganisms also escape through nose
and throat secretions
• Wear a mask
• Do not talk directly into patient’s face
• Stay home if you are sick
• Practice good cough etiquette (cover your
coughs and sneezes)
• Perform good hand hygiene

Gastrointestinal Tract. Microorganisms • Handle and dispose of body secretions

that leave the body of the infected person properly
by means of body secretions (e.g. stool and • Use personal protective equipment
vomit). For example hepatitis A virus is shed • Perform good housekeeping
in the stool of the infected person. • Perform good hand hygiene

Skin. Microorganisms that leave the body of • Dispose of wound dressings properly
the infected person by wound drainage or • Use personal protective equipment (PPE)
through skin lesions. • Perform good hand hygiene

Blood. Infection may occur when someone’s • Safe handling of sharps

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blood gets into another person’s system.
• Use gloves for procedures where there is
risk of exposure to blood
• Use care in obtaining, transporting and
processing specimens
• Perform good hand hygiene

• Mode of Transmission. Since microorganisms cannot travel on their own, they require a
vehicle to carry them to other persons and places.

• Mode of Entry. The path for the microorganism to get into a new host (the reverse of the
portal of exit). The mode of entry refers to the method by which the pathogens enters the person.

Pathogens enter the body by:

• inhalation (e.g. respiratory tract)
• ingestion (e.g .GI tract)
• absorption (e.g. mucous membranes of eyes)
• break in skin (e.g. needle stick, cut)
• introduction by medical procedures (e.g. catheters)

Modes of Entry Breaking the Link

Respiratory Tract. Small particles that
result from evaporation of droplets from the
respiratory tract of infected persons remain
suspended in the air of poorly ventilated
spaces for periods of time. The infectious
microorganisms can be inhaled by a well
person who may then become infected with
the disease.
• Wear a mask/respirator
• Maintain good ventilation
• Isolate those with respiratory symptoms
• Good respiratory hygiene/etiquette
practices
• Perform good hand hygiene

Gastrointestinal Tract. Pathogenic • Dispose of body excretions carefully

microorganisms enter the body of a new host
when food or water contaminated by feces is
ingested (fecal/oral route).
Mucous membranes. Absorption of
microorganisms through exposed eyes, nose
and mouth.
Skin. Microorganisms enter the body when
a person comes into contact with wound
drainage or skin secretions.
• Careful food handling
• Perform good housekeeping
• Wear appropriate personal protective
equipment
• Perform good hand hygiene
• Protect eyes, nose and mouth with face
shield during procedures likely to generate
splashes or sprays
• Carry out good housekeeping
• Perform good hand hygiene
• Dispose of wound dressings carefully and
properly
• Wear personal protective equipment
• Maintain healthy intact skin
• Perform good hand hygiene
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• Susceptible Host. The future host is the person who is next exposed to the pathogen. The
microorganism may spread to another person but does not develop into an infection if the
person’s immune system can fight it off. They may however become a ‘carrier’ without
symptoms, able to then be the next ‘mode of transmission’ to another ‘susceptible host’. Once
the host is infected, he/she may become a reservoir for future transmission of the disease.

Susceptible Hosts Control

• Children who are very young
• People who are very old
• People on inadequate diets
• Separate high risk individuals from persons
with known or potential infections
• Provide nutritional supplements to persons
on inadequate diets

• People who are chronically ill • Vaccinate against vaccine preventable

diseases
• People receiving medical therapy such as
chemotherapy or high doses of steroids • Maintain proper sanitation of air and
environment
• People who are already ill
• Diagnose and treat underlying disease
• People with open wounds

B. Current Global trends and statistics of infection

 The Global HIV/AIDS Epidemic
- HIV, the virus that causes AIDS, is one of the world’s most serious public health
challenges. But there is a global commitment to stopping new HIV infections and
ensuring that everyone with HIV has access to HIV treatment.

- Number of People with HIV—There were approximately 37.9 million people across the
globe with HIV/AIDS in 2018. Of these, 36.2 million were adults and 1.7 million were
children (<15 years old).

Global Statistics
37.9 million People worldwide are currently living with HIV or AIDS.
The Global HIV/AIDS Epidemic
HIV, the virus that causes AIDS, is one of the world’s most serious public health challenges. But
there is a global commitment to stopping new HIV infections and ensuring that everyone with
HIV has access to HIV treatment.

According to UNAIDS:

Number of People with HIV—There were approximately 37.9 million people across the globe
with HIV/AIDS in 2018. Of these, 36.2 million were adults and 1.7 million were children (<15
years old).
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New HIV Infections—an estimated 1.7 million individuals worldwide became newly infected
with HIV in 2018. (New HIV infections, or “HIV incidence,” refers to the estimated number of
people who newly acquired the HIV virus during a year, which is different from the number of
people diagnosed with HIV during a year. Some people may have HIV but not know it.) Of these
new infections:

 1.6 million infections were among people ages 15 and older

 160,000 infections were among children ages 0-14

HIV Testing—Approximately 79% of people with HIV globally knew their HIV status in 2018.
The remaining 21% (about 8.1 million people) still need access to HIV testing services. HIV
testing is an essential gateway to HIV prevention, treatment, and care and support services.

HIV Treatment Access—in 2018, 23.3 million people with HIV (62%) were accessing
antiretroviral therapy (ART) globally, an increase of 1.6 million since 2017 and up from 8
million in 2010. HIV treatment access is key to the global effort to end AIDS as a public health
threat. People with HIV who are aware of their status, take ART daily as prescribed, and get and
keep an undetectable viral load can live long, healthy lives and have effectively no risk of
sexually transmitting HIV to their HIV-negative partners.

HIV Care Continuum—the term HIV care continuum refers to the sequence of steps a person
with HIV takes from diagnosis through receiving treatment until his or her viral load is
suppressed to undetectable levels. Each step in the continuum is marked by an assessment of the
number of people who have reached that stage. Tracking progress toward those goals, UNAIDS
reports that in 2018, of all people with HIV worldwide:

 79% knew their HIV status

 78% of all people who knew their status were accessing ART
 86% of all people receiving ART had viral suppression

Mother-to-Child Transmission—in 2018, 92% of pregnant women with HIV received ART to
prevent transmitting HIV to their babies during pregnancy and childbirth and to protect their own
health. This is compared to 49% in 2010.

AIDS-related Deaths—AIDS-related deaths have been reduced by more than 55% since the
peak in 2004. In 2018, around 770,000 people died from AIDS-related illnesses worldwide,
compared to 1.2 million in 2010 and 1.7 million in 2004.

Regional Impact—the vast majority of people with HIV are in low- and middle-income
countries. In 2018, there were 20.6 million people with HIV (57%) in eastern and southern
Africa, 5.0 million (13%) in western and central Africa, 5.9 million (16%) in Asia and the
Pacific, and 2.2 million (6%) in Western and Central Europe and North America.

Challenges and Progress

 Too many people with HIV or at risk for HIV still do not have access to prevention, care,
and treatment, and there is still no cure.
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 In recent years, UNAIDS cautions that the pace of progress in reducing new HIV
infections, increasing access to treatment, and ending AIDS-related deaths is slowing
down with some countries making impressive gains while others are experiencing rises in
new HIV infections and AIDS-related deaths.

References:

www.WHO.org retrieved on March 17, 2020

https://www.niinfectioncontrolmanual.net/basic-principles retrieved on March 17, 2020

www.engageinlearning.com retrieved on March 17, 2020

https://www.gov.nu.ca/sites/default/files/files/3_%20%20Chain%20of%20Infection%20-
%20march%205%20-%20low%20res.pdf. Retrieved on March 18, 2020

https://www.hiv.gov/hiv-basics/overview/data-and-trends/global-statistics. Retrieved on March

19, 2020