Hospital-Acquired Infections

306 Pages·2005·13.94 MB·English

by  Zsolt Filetoth

Hospital-
uired
P
ac
In
ection
and Control
Causes
ZSOLTF ILETOTHM, D, MSC
Head of Clinical Epidemiology Unit of the
National Institute of Traumatology, Budapest, Hungary
and
Consultant in Infectious Disease and Epidemiology,
National Institute of Neurosurgery, Budapest, Hungary

W
W H U R R PUBLISHERS
L O N D O N A N D P H I L A D E L P H I A

Hospital-acquiredI nfection
Control
Causes and
In consequence of my conviction I must affirm that only God knows the
number of patients who went prematurely to their graves because of me. I have
examined corpses to an extent equalled by few other obstetricians. If I say this
also of another physician, my intention is only to bring to consciousness a truth
that, to humanity’s great misfortune, has remained unknown through so many
centuries. No matter how painful and oppressive such a recognition may be,
the remedy does not lie in suppression. If the misfortune is not to persist
forever, then this truth must be made known to everyone concerned.
Ip.nacz Semmelweis, ?he Etiologv, Concept, and Prophylaxis of Childbed Fever
Hospital-
uired
P
ac
In
ection
and Control
Causes
ZSOLTF ILETOTHM, D, MSC
Head of Clinical Epidemiology Unit of the
National Institute of Traumatology, Budapest, Hungary
and
Consultant in Infectious Disease and Epidemiology,
National Institute of Neurosurgery, Budapest, Hungary

W
W H U R R PUBLISHERS
L O N D O N A N D P H I L A D E L P H I A
02 003 Whurr Publishers Ltd
First published 2003
by Whurr Publishers Ltd
19b Compton Terrace, London N 1 2UN England and
325 Chestnut Street, Philadelphia PA 19106 USA
All rights reserved. No part of this publication may be
reproduced, stored in a retrieval system, or transmitted in any form
or by any means, electronic, mechanical, photocopying, recording
or otherwise, without the prior permission of
Whurr Publishers Limited.
This publication is sold subject to the conditions that it shall not, by
way of trade or otherwise, be lent, resold, hired out, or otherwise
circulated without the publisher’s prior consent in any form of
binding or cover other than that in which it is published and
without a similar condition including this condition being imposed
upon any subsequent purchaser.
Library Cataloguing in Publication Data
British
A catalogue record for this book is available from the British Library.
ISBN: 1 86156 344 2

Printed and bound in the UK by Athenaeum Press Ltd,
Gateshead, Tyne & Wear.
Contents
The author vii
Acknowledgements
ix
Preface ...
xi
Introduction
Xlll
Chapter 1 1
Causes and determinants of hospital-acquired infection
Chapter 2 53
Infection and its characteristics
Chanter 3 74
The chain of infection and the transmission of an infective agent
Chapter 4 97
Definitions and general characteristics of infections in hospitals
Chapter 5 116
Preventive strategies for hospital-acquired infection
Chapter 6 180
Common hospital-acquired infections in developed countries
Chapter 7 220
Infection control and surveillance
References 252
V
vi Hospital Acquired Infection
Bibliography
262
Annexe 1: American National Standards in United States
263
regulating sterilization in hospitals and in industry
Annexe 2: Standards of the European Union regulating
266
sterilization in hospitals
Annexe 3: Required amount of disinfectant for an appropriate
268
concentration of total solution in the SI system
Index
269
The author
Zsolt Filetoth was born in 1961 and grew up in Hungary. In 1979, after
finishing high school in Budapest, he entered medical school in St Peters-
burg, Russia, where he graduated as an MD in 1985.
In 1985 he became a resident and clinical fellow in infectious disease
and received training in hospital hygiene in Hungary. He organized the
first course in Hungary in hospital-acquired infection for senior nurses and
operating room nurses, which was recognized by the Postgraduate School
for Nurses of Hungary. In 1992 and 1993 he studied basic epidemiology in
the USA at the Centers for Disease Control and Prevention, Atlanta, Geor-
gia, completing courses in Hospital Epidemiology and International
Epidemic Intelligence Services.
In 1995 he studied at the Public Health Laboratory Service, London,
and received individual training in hospital infection control at the Middle-
sex Hospital. In 1998 he was awarded an MSc degree by the University of
London and the Diploma in Communicable Disease Epidemiology by the

London School of Hygiene and Tropical Medicine.
Since 1994 he has been head of the Clinical Epidemiology Department
of the National Institute of Traumatology, Budapest, Hungary. In 1999 he
was appointed as a consultant in infectious disease and epidemiology at the
National Institute of Neurosurgery, Budapest, Hungary.
Professionally, he is interested in the epidemiology of infectious diseases,
especially in the surveillance of nosocomial infections, and in antibiotic
policy. He is practice oriented, collaborating in molecular epidemiology at
the Institute of Medical Microbiology of the Semmelweis University of
Budapest, Hungary. He is an invited lecturer in communicable disease
epidemiology at medical schools throughout Hungary, and has presented
more than 40 lectures in hospital infection control.
vii