Paper I — 2024 March (Supplementary) (2019 Scheme) — Q7
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Paper I
2024 March (Supplementary) (2019 Scheme) · 100 marks · 180 min
Question
Define Health Care Associated Infection. Mention the various types of HAI and their
preventive measures. (2+2+4)
(PTO)
Q710 marksShort Essays
Answer
Health Care Associated Infection (HAI): an infection acquired by a patient during the course of receiving treatment for another condition in a healthcare setting, that was neither present nor incubating at the time of admission — typically manifesting 48 hours or more after admission (or, for surgical site infections, within 30 days of a procedure, or up to a year if an implant is involved).
Various types of HAI:
Surgical Site Infection (SSI) — infection occurring at or near the surgical incision site.
Central Line-Associated Bloodstream Infection (CLABSI) — associated with central venous catheterization.
Ventilator-Associated Pneumonia (VAP) — pneumonia developing in patients on mechanical ventilation.
Clostridioides difficile-associated diarrhoea — often related to antibiotic-induced disruption of normal gut flora in hospitalized patients.
Preventive measures:
Hand hygiene — strict compliance with WHO’s “5 moments for hand hygiene,” the single most effective and important preventive measure across all HAI types.
SSI prevention — appropriate pre-operative antiseptic skin preparation, surgical hand scrub, aseptic surgical technique, and appropriately timed peri-operative antibiotic prophylaxis.
CAUTI prevention — aseptic catheter insertion technique, use of a closed drainage system, and prompt catheter removal once no longer clinically indicated (minimizing duration of catheterization is the single strongest preventive factor).
CLABSI prevention — maximal sterile barrier precautions during insertion, chlorhexidine skin antisepsis, optimal catheter site selection, and daily review of the continued necessity of the line.
VAP prevention — elevation of the head of the bed (30–45°), regular oral care with antiseptic solution, and daily assessment of readiness for extubation (“sedation vacation” and weaning protocols).
General measures applicable across all types — standard precautions for every patient, transmission-based (contact/droplet/airborne) precautions for patients with known/suspected transmissible infection, environmental cleaning/disinfection of surfaces and equipment, antimicrobial stewardship to limit resistance development, active surveillance for HAI, and a functioning hospital infection control committee overseeing policy, training, and compliance monitoring.
