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Pediatric Practice: Infectious DiseasePediatric Practice: Infectious Disease

Section 1. Practical Aspects > 

Chapter 5. Infection Control in the Hospital

Robert Seese, Johanna Goldfarb
Topics Discussed: infectious disease prevention / control; nosocomial infection; washing hands.
Sections: Transmission of Infections in the Hospital Setting, Infection Control Considerations for the Hospital Setting, References.
Excerpt:"Hand hygiene is the most important infection-control practice, whether in the hospital, the clinic, or at home. By interrupting the transmission of pathogens, hand hygiene protects not only patients, but also the health care workers (HCWs) who care for them. Monitoring and encouraging compliance with proper hand hygiene is one of the most important goals of every infection control program.Soaps are detergents that remove organic substances and soiling materials from the hands, removing pathogens mechanically. Plain soaps without any antimicrobial additives reduce the burden of bacteria on the skin. A 15-second handwash can reduce the number of pathogenic bacteria on the skin by 0.6–1.1 log10.1,16 However, bar soaps can become colonized with gram-negative bacteria and can become a fomite for spread of pathogens.17 Antimicrobial agents have been added to soaps and most hospitals now use antimicrobial liquid-dispensed soaps to avoid this problem. The most common antimicrobial additives in soaps are triclosan and chlorhexidine, which act to destabilize the cytoplasmic membrane of bacteria and yeast. Chlorhexidine also has excellent activity against enveloped viruses like HIV, HSV, RSV, influenza, and hepatitis viruses. Technique is important to be effective (Table 5–1)...."
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