Management and Prevention Strategies

The management of hospital infections is compounded by factors intricately associated with the
dissemination of multi-resistant organisms (MROs), encompassing a contaminated healthcare
facility environment and a deficiency in preventive measures implemented by healthcare
professionals. [1] Therefore, infection control efforts should prioritize activities and strategies
necessitating extensive collaboration to effectively curtail the transmission of infections. [2]

Ensuring rigorous environmental cleanliness constitutes a fundamental element in the prevention

and management of infections. The primary objective of such environmental sanitation is to
attenuate the presence of communicable microorganisms typically found on various surfaces. By
diminishing the population of pathogens, the likelihood of transmitting infectious agents from
objects to individuals is subsequently lowered, thereby mitigating instances of cross-infection. [3]

Standard precautions are imperative to mitigate the transmission of infections, particularly those
resistant to treatment. These precautions encompass a heightened institutional commitment to
hand hygiene practices, given that the hands of healthcare personnel constitute the predominant
vector for the transfer of healthcare-associated pathogens both between patients and within the
healthcare setting. Additionally, standard precautions involve the utilization of personal protective
equipment such as gloves, gowns, and masks, along with the judicious placement of patients and
the rigorous cleaning and disinfection of patient care equipment [2] also removing unnecessary
catheters, the maintenance of line (sterile access, daily review of site, chlorhexidine body wash),
the insertion of catheters using aseptic technique and sterile equipment. [1]

The growing concern within the community stems from the observed challenges and limitations of
various strategies to contain the dissemination of hospital infections. These challenges have led to
elevated morbidity and mortality rates attributable to infections resistant to antimicrobial agents,
which often develop during patients' hospital stays. [3]

Other Infection control measures employed within hospital settings include patient screening,
cohorting, and surveillance. Numerous countries have effectively mitigated the incidence of
infections through the implementation of nationwide control strategies, exemplified by the
“search and destroy” (S&D). Measures of S&D include the segregation of positive patients;
anticipatory separation and assessment and evaluation of high-risk cases; screening of patients;
assessment of potential carriers; total decontamination where required and stopping new
admissions in areas where more than one carrier found amongst hospitalized patients and the
surveillance that scan and monitor trends of infection rates.[3] Furthermore, it is imperative to
incorporate the optimization of antibiotic utilization as an integral component of the strategies
aimed at preventing hospital infections that are resistant to antibiotics.

For the effective optimization of antibiotic treatments, it is necessary to promptly collect blood
cultures and samples from infectious sites. However, it is widely recognized that the initiation of
antibiotic therapy should occur without delay, contingent upon a swift diagnosis, and the selection
of the appropriate empiric drug for treatment. Consequently, possessing a comprehensive
understanding of the local epidemiology of antimicrobial resistance assumes paramount
significance, particularly within time-sensitive medical contexts. In spite of the disconcerting
prevalence of multidrug-resistant (MDR) infections, the accessibility of novel antimicrobial agents
remains limited. This presents a formidable challenge for healthcare professionals, particularly
those operating within resource-constrained settings, notably in critical care units and emergency
departments where the timing of therapy is of utmost concern. Also, the establishment of
centralized surveillance programs and the utilization of electronic health records to automate
reporting are crucial initiatives. Additionally, the periodic updating of existing guidelines should be
geared towards providing objective insights into the optimal duration of treatment and
establishing specific criteria for determining the appropriateness of shorter or longer courses of
antimicrobial therapy [4].

References
Fernando , S. A., Gray , T. J., & Gottlieb , T. (2017 Dec). Healthcare-acquired infections: prevention
strategies. . Intern Med J. , 47(12):1341-1351. doi: 10.1111/imj.13642. PMID: 29224205.

Habboush , Y., Yarrarapu , S., & Guzman , N. (2023 Jul 24). Infection Control. In: StatPearls
[Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan–, PMID: 30085559.

Haque , M., McKimm, J., Sartelli , M., Dhingra , S., Labricciosa , F., Islam , S., . . . Charan , J. (2020
Sep 28). Strategies to Prevent Healthcare-Associated Infections: A Narrative Overview.
Risk Manag Healthc Policy, 13:1765-1780. doi: 10.2147/RMHP.S269315. PMID: 33061710;
PMCID: PMC7532064.

Vieceli , T., & Rello , J. (2022 Dec). Optimization of antimicrobial prescription in the hospital. Eur J
Intern Med., 106:39-44. doi: 10.1016/j.ejim.2022.08.035. Epub 2022 Sep 11. PMID:
36100471.
References
1

Fernando SA, Gray TJ, Gottlieb T. Healthcare-acquired infections: prevention strategies. Intern
Med J. 2017 Dec;47(12):1341-1351. doi: 10.1111/imj.13642. PMID: 29224205.

(Fernando , Gray , & Gottlieb , 2017 Dec)

Habboush Y, Yarrarapu SNS, Guzman N. Infection Control. 2023 Jul 24. In: StatPearls [Internet].
Treasure Island (FL): StatPearls Publishing; 2023 Jan–. PMID: 30085559.

(Habboush , Yarrarapu , & Guzman , 2023 Jul 24)

Haque M, McKimm J, Sartelli M, Dhingra S, Labricciosa FM, Islam S, Jahan D, Nusrat T, Chowdhury
TS, Coccolini F, Iskandar K, Catena F, Charan J. Strategies to Prevent Healthcare-Associated
Infections: A Narrative Overview. Risk Manag Healthc Policy. 2020 Sep 28;13:1765-1780. doi:
10.2147/RMHP.S269315. PMID: 33061710; PMCID: PMC7532064.

(Haque , y otros, 2020 Sep 28)

Vieceli T, Rello J. Optimization of antimicrobial prescription in the hospital. Eur J Intern Med. 2022
Dec;106:39-44. doi: 10.1016/j.ejim.2022.08.035. Epub 2022 Sep 11. PMID: 36100471.

(Vieceli & Rello , 2022 Dec)