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Hospital-Associated Infections and Chain of Infection

welcome to this video on

hospital-associated infections and the

chain of infection a couple things to

start out with hospital-associated

infections are sometimes called acquired

I've noticed that hospitals have moved

away from this language because saying

hospital acquired infections is

basically like admitting guilt which

probably opens them up for a lot more

lawsuits so usually you'll see

infections that someone gets in a

hospital called hospital-associated

infections and then in this video we'll

also briefly go through the chain of

infection about how diseases can be

passed from one person to another but

we're mostly focusing on this situation

in a medical setting so for a hospital

associated infection you have to have

three ingredients ingredient number one

is immuno compromised patients for some

reason of all of these patients will

have less ability to fight back while

they are hospitalized so this first

example right here and let's do these

ones in green so immunocompromised

patients this is the first ingredient

and why might they be immunocompromised

well I'll use a green pen for these so

first this first person says what I've

messed up my flora they have dysbiosis

this word is somewhat new on the medical

scene but it basically means bad biology

or not having healthy amounts of normal

flora or and they don't have enough of

them or they are out of whack or out of

balance something like that okay this

person saying I'm already so sick so

maybe this person has an already is has

an infection what we would call a

primary infection that could then lead

them to get a secondary infection in the

hospital or maybe they have a

pre-existing condition like an

autoimmune disease

okay this person says my body is

ensuring I don't reject my baby so

there's a little baby in there this lady

is pregnant

pregnancy is a state of

immunocompromised and the balance has to

be found by the body the immune system

has to ratchet down its immune response

just enough so that the mother's white

blood cells don't attack this new person

inside of her but at the same time keep

her immune system strong enough so that

she doesn't die of an illness while she

is pregnant so we do sometimes see

complications that go awry with this

situation but that would be a topic for

another very fun video okay in this

situation here's a little kiddo

saying I'm so young my white blood cells

are still learning lots or yours might

say they still have a lot to learn in

this video I wrote out the page twice

and for the one that you have I like the

way I phrase things better but so this

would be the very young and you're

probably not surprised that this one is

the very old my body is wearing out okay

so that's ingredient number one

ingredient number two that sets the

stage for more common

hospital-associated infections are

antibiotic resistant organisms

antibiotic resistant I'm just gonna say

microbes because fungus not just

bacteria can be kind of known for this

so antibiotic resistant microbes in the

news these are called the superbugs and

super bugs can be grande positive

gram-negative they can be spheres they

can be rods but let's just put a few

different scenarios on here they can be

endows former spore formers like

Clostridium

you say so I just color some of those

purple and some pink and I like to put a

couple green endospores in there

okay so what are these guys saying these

microbes have mutations and traits that

allow them to thrive when normal

bacteria are kept away that's what

happens in a hospital they like to share

their antibiotic resistant properties

with each other so if one of them has a

gene for antibiotic resistance they will

give it to the others that live around

them and then they're all immune from

our antibiotics and then this one's

saying anybody want my plasmid they're

happy to share and the reason they're so

happy to share is because by living in a

little ecosystem called a biofilm then

they're able to pool together their

resources that are allowed them to be

resistant to cleaning efforts like

bleach or something and antibiotics if

they're given to a patient so both in

the person's body and on the surfaces in

the hospital so these kind of situations

are especially going to be particularly

common after a patient receives

antibiotics so c-diff is a classic

example a person is given antibiotics

and then they develop a very bad case of

diarrhea that is caused by classic

diarrheal post or even during antibiotic

infection and then that has to be

treated with a different kind of

antibiotic so it's all like this vicious

cycle okay so then let's go on oh I

should also say that a lot of these

microbes apparently can't thrive very

well

when there are plenty of normal flora

around so some naturopaths will actually

recommend that a person that has an

antibiotic resistant infection that

they're having trouble beating spends

more time in the woods in the dirt

outside and tries to repopulate

supposedly their normal and healthy

flora this sort of thing hasn't been

clinically tested very well but I

wouldn't be surprised if you hear more

and more about that sort of effort in

the years to come so instead of treating

infections with antibiotics some more

alternative therapies might be to try

and re-establish the normal flora and

once they are real established they kick

out these purebred over here that are

only able to thrive when out without the

normal ones around okay the third

ingredient in hospital-associated

infections is over worked hospitals so

I'm gonna do orange for this and it

doesn't necessarily need to be a

hospital it could also be you know a

doctor's office more of a private clinic

but overworked hospitals and this could

be the medical staff themselves I've

seen 20 patients today I've heard it can

sometimes even be 40 I don't know in

this bed and the ers may be saying I've

had 10 patients lay here already today

so when we talk about that we could say

that the staff are overworked and the

staff could be the doctors the nurses

certainly the nursing assistants and how

about the cleaning staff themselves all

these people are overworked the

facilities are overworked what that

means is it takes that maybe they're

having trouble getting the bedding

cleaned the beds the sheets this

surfaces the curtains all of these

things then can become harbingers of

superbugs

so let's last look at what's called the

chain of infection now the chain of

infection I'll highlight this in yellow

the chain of infection could refer to

any infection not just

hospital-associated infections but I am

going to just use that on this page so

in this first circle so see all these

things are connected and if you can

break any of these connections and

potentially you can stop the disease

from being passed on so first of all you

have like an infectious agent that could

be the bacteria or the virus or the

fungus whatever the causative agent it

is and then you have to think about the

reservoir where does it normally live

normal living place that could be inside

of people it could be on surfaces it

could be in water it could be in a

different animal all of these things or

the soil all of those would be

considered a part of a reservoir then

there has to be what's called portal and

portal just means doorway of exit so how

does the microbe get from the water

let's say out of the water and then the

next would be the mode of transmission

transmission would it be like a bite

OUP's mode of transmission how is it

through needles all of these kind of

things then we have a portal of entry

and that's how is it going to get in to

its next victim and that could be like

an open wound it could it could actually

be it ingested it could be on the skin

all of these could be examples of how it

gets in it could be a needle puncture

actually

and then the last is the susceptible

host so that means that even if the

organism gets in to someone that doesn't

mean they get sick so if any of these

things can be interrupted then you could

actually stop the passing of this

disease so again

is it a bacteria is it a virus here

would be the name of the organism where

is it found normally in nature that's

its reservoir how does it get out of its

reservoir at all so that it's able to

potentially be passed and then able to

get inside of someone that actually gets

sick by it so this is called the chain

of infection okay that's it for this

video see you in the next one