Infection control

Despite healthcare-associated infections (HAIs) being preventable, the incidence is increasing, leading to morbidity, mortality and increased healthcare costs. The aim of infection control practices is to prevent the transmission of infections between patients and healthcare providers. The earliest published infection control reference in anaesthesia was in 1873. Infection prevention and control involves every corner of the hospital. From environmental and equipment cleaning and decontamination to infection control precautions when managing infectious patients to the most basic of effective interventions, hand hygiene. There are additional sources of risk in anaesthesia practice; injection and drug administration practices, the insertion of invasive lines, surgical antibiotic prophylaxis and the performance of regional and neuraxial anaesthesia. Anaesthetists should endeavour to be part of the solution and not part of the problem. Modest changes in our daily infection control practices, such as appropriate and adequate hand hygiene; surface, environmental and equipment decontamination; correct handling and use of drugs, fluids, intravenous administration sets; and meticulous care to sterility and cleanliness when performing invasive procedures can have a significant impact on patient outcomes. Knowledge of local infection prevention and control guidelines is the first step to adherence and building the central pillars to minimise the risk of HAIs. HAIs increase morbidity, mortality and healthcare expenses. These infections are avoidable and yet the incidence is increasing. Surgical site infections (SSIs) are the most common HAIs with the highest expenditure, increasing hospital stay by up to 11 days.(1) The World Health Organization (WHO)(2) reports that 3.5-12% of hospitalised patients in developed countries will develop an HAI and this is almost doubled in developing countries at 5.7-19.1%. The GlobalSurg Collaborative(3) found the prevalence of SSIs in lower-and-middle income countries (LMICs) to be 2-20 times higher than in higher income countries (HICs). In South Africa, one in seven patients is at risk of developing an HAI.(4)