NOSOCOMIAL INFECTION OUTREAK

1. INTRODUCTION
Objective of the report
This report aims to investigate and report on a recent outbreak or nosocomial infections in
the Hospital, describing the factors contributing to its spread and proposing prevention
measures. the implementation of control and biosecurity strategies.

Scope of the report

This report focuses on an outbreak recorded in the intensive care area and in the surgical
area of the Hospital during the months of June 'to August 2023. Postoperative patients and
those in critical condition who presented infections of unknown origin were included

Background of the problem

Nosocomial infections represent a global health problem, affecting both patients and
healthcare personnel. These infections are often caused by resistant pathogens due to the
intensive use of antibiotics and the performance of' invasive procedures. The recent
outbreak in the Hospital has shown a high rate of infections, with an increase of 20%
compared to the previous year. Not only has it increased morbidity and mortality, it has
also consequently put additional pressure on hospital resources, prioritizing the urgent
need to review and strengthen biosecurity and infection control measures in critical areas.
2.THEORETlCAL FRAMEWORK
2.1. KEY CONCEPTS RELATED TO BIOSECURITY
 Nosocomial Infections
Nosocomial infections are those that patients acquire within health facilities and that were
not present or in the incubation period at the time of admission.

 Risk Factors In Hospital Environments

• Invasive procedures: Any intervention that involves the introduction of medical devices into the
body, such as catheters, ventilators and probes, increases the risk of infection because they alter
the body's natural barriers.
• Excessive use of antibiotics: Frequent administration contributes to the emergence of multi-
resistant microorganisms,
• Conditions of the hospital environment: Insufficient hygiene on surfaces, equipment and
common areas, together with a high density of patients in a small space, facilitates the
transmission of pathogens.
• Direct contact of health personnel with patients: Healthcare personnel act as a potential
vector of infections if hygiene protocols and the use of personal protective equipment (PPE)
are not properly followed.
 • Compromised Immune system: Patients in intensive care areas or undergoing high-risk
procedures are specialty vulnerable to infections.
• Use of personal protective equipment, such as gloves, masks, gowns. and glasses. to
reduce the transmission of pathogens.
• All equipment that has direct contact with patients must be disinfected and, in some
cases, sterilized after each use to prevent the transmission of pathogens.
• Isolate patients with highly contagious infections to reduce the risk of transmission.
• Epidemiological surveillance and continuous monitoring of infection rates allows
outbreaks to be identified early and corrective measures to be taken immediately.

2.2. APPLICABLE RULES AND REGULATIONS

 International Standards of the World Health Organization (WHO)
The standards include recommendations for hand hygiene, proper use of PPE, sterilization of
medical equipment and proper disposal of hospital waste. In addition, WHO promotes awareness
and education campaigns for health personnel and encourages the implementation of surveillance
systems for nosocomial infections.
 Regulations of the Ministry of Health
Each country adapts and establishes its own biosafety standards, which are adjusted to
local needs and conditions, In the context of nosocomial infections, the Ministry of
Health establishes specific guidelines such as:
 • Infection control protocols: Standards on cleaning and disinfection procedures in hospital
areas, and the mandatory use of PPE in critical areas.
 Regulations of the Ministry of Health
Each country adapts and establishes its own biosafety standards, which are adjusted to
local needs and conditions. In the context of nosocomial infections, the Ministry of Health
establishes specific guidelines such as:

 Infection control protocols: Standards on cleaning and disinfection procedures in

hospital areas, and the mandatory use of PPE in critical areas,
 Hospital waste management: Standards for the collection, transportation. and
disposal of medical waste, especially those that may be infectious or
contaminating.
 Staff training: Requirement of ongoing training programs on biosafety and infection
control issues for all staff working in the hospital.
 Periodic evaluations and audits: The Ministry of Health carries out these to ensure
that hospitals comply with biosafety standards and thus reduce the incidence of
nosocomial infections.

3. METHODOLOGY
 Description of methods used to collect information:
Review of clinical records:
 Patients affected during the outbreak, with the aim of identifying common patterns
and characteristics in infections. It also included the type of procedure performed,
use of invasive devices. previous antibiotic treatments and duration of
hospitalization.

Structured interviews:
Patients affected during the outbreak, with the aim of identifying common patterns
and characteristics in infections. It also included the type of procedure performed.
use of invasive devices, previous antibiotic treatments and duration of
hospitalization.

Structured interviews:
Structured interviews were conducted with nursing staff, doctors and cleaning staff
in the affected areas. These interviews explored hygiene practices, perception of
infection risk and compliance with biosafety protocols, providing valuable
information that may have influenced the spread of infections.

Direct observation:
Inspections were conducted in the intensive care and surgical areas to assess
hygiene conditions and compliance with biosafety protocols. These observations
allowed us to identify possible areas for improvement in surface cleaning,
equipment management and hospital waste disposal
  Tools and techniques used:
 Microbiological sampling:
Anonymous questionnaires were distributed among staff in the intensive care and
surgical areas to collect information on potential risk practices, compliance with hygiene
protocols, and use of personal protective equipment (PPE).
 Statistical analysis:
A comparative analysis of current infection rates with the hospital's historical average
was performed. This analysis included the calculation of infection rates adjusted by
patient type and hospital area, which helped contextualize the magnitude of the
outbreak

4. RESULTS

 Presentation of the data obtained:

• 15 confirmed cases of nosocomial infections were documented in the last three
months* with a higher incidence in the intensive care area.
• The most common infections were urinary tract infections, surgical wound infections
and pneumonia associated with mechanical ventilation.

 Use of tables and graphs:

• Table of distribution of cases by type of infection and location
 Distribution of Csses tyc:e cf Infection and Locaticm

5. ANALYSIS
 Interpretation of the results:
• A correlation was observed between the outbreak and insufficient hygiene
practices in the use and disinfection of equipment, especially catheters and
probes. Additionally, there was low compliance in regularly changing gloves and
masks between patients.
 • Sterilization procedures showed deficiencies, possibly due to staff overload and
tack of adequate supervision.
 Comparison with previous data or standards:
• Infection rates were 15-20% above the reference standards set by the hospital
indicating a significant deviation in infection control.
6. CONCLUSIONS

 Summary of the most important findings:

•It was identified that the main cause of the outbreak is non-compliance with biosafety
protocols, along with a lack of continuous training for health personnel.
•The pathogens detected are highly resistant to conventional treatments, which
complicates the recovery of patients and requires greater caution in infection control.

 Answer to research questions: The research confirmed the relationship between the
deficiency in biosafety practices and the increase in infections, highlighting the need for
immediate improvements.

7. RECOMMENDATION
 Improvement proposals to prevent future incidents:
• Training: Offer regular biosafety courses to all staff, with emphasis on the correct use
of medical equipment and personal protection.
• Cleaning and disinfection: Increase the frequency of cleaning and sterilization,
especially in high-risk areas such as the ICU and operating rooms.

• Monitoring: Carry out weekly inspections to verify that hygiene protocols and use of
protective equipment are met.
• Antibiotic use: Establish standards for more responsible use of antibiotics and promote
cultures before administration.
• Epidemiological surveillance: Create a team to monitor new cases and audit
biosafety practices.
• Infrastructure: Evaluate and improve ventilation systems, waste management and
work flows in critical areas.