Public Health Microbiology: Infection Prevention and Control

PUBLIC HEALTH MICROBIOLOGY: INFECTION PREVENTION AND CONTROL

INTRODUCTION

The critical and defining element of all infections and infectious diseases is their capacity to spread. The fact that infection can spread from person to person (patient to patient) by direct contact, or by the hands and clothes of healthcare workers, or by contamination of equipment or the environment, means that there is a public health and infection control aspect to all infections. For every patient who acquires an infection there is a need for specific treatment for that patient, but we also need to address the two infection control issues from where (or from whom) has the infection come, and how can we minimize the risk of it spreading to others. This is the subject of infection prevention and control.

Among the broad range of infections, those that develop as complications of other illnesses or of the treatment of those illnesses, possibly by cross-infection but also by infection from the patient’s own bacterial flora, are a major concern to health services throughout the world. These are variously known as hospital acquired infections, hospital cross-infections, or more generally now, healthcare-associated infections (HCAIs) to reflect the fact that they occur in patients throughout health and social care settings, not just those in hospital. An increasingly elderly population with a range of chronic medical conditions and the tremendous success of modern medical and surgical practice in increasing life expectancy and treating previously fatal conditions means that health services have to deal with many patients who are highly vulnerable to infection. Invasive clinical procedures are an essential part of most medical care, as are treatment requirements causing significant immuno-suppression, both of which are key risks for the patient developing an HCAI.

One of the main responsibilities of all clinicians is that they should, as a priority, not harm their patients through the investigations and treatment they give. Clearly, with modern medical and surgical practice, all risks cannot be eliminated, but the risks must be minimized, in particular the risk of these vulnerable patients acquiring an infection as a direct result of their healthcare. Hence there is a specific focus in all health services on the of HCAI.