Reference Manual for
Health Care Facilities with Limited Resources
Infection
Prevention
and Control.
Module 1. Introduction to Infection Prevention
and Control
Authors
Melanie S. Curless, MPH, RN, CIC
LaToya A. Forrester, MPH, CIC
Polly A. Trexler, MS, CIC
,The authors have made every effort to check the accuracy of all information, the dosages of any drugs, and
instructions for use of any devices or equipment. Because the science of infection prevention and control is rapidly
advancing and the knowledge base continues to expand, readers are advised to check current product information
provided by the manufacturer of:
• Each drug, to verify the recommended dose, method of administration, and precautions for use
• Each device, instrument, or piece of equipment to verify recommendations for use and/or operating
instructions
In addition, all forms, instructions, checklists, guidelines, and examples are intended as resources to be used and
adapted to meet national and local health care settings’ needs and requirements. Finally, neither the authors,
editors, nor the Jhpiego Corporation assume liability for any injury and/or damage to persons or property arising
from this publication.
Jhpiego is a nonprofit global leader in the creation and delivery of transformative health care solutions that save lives.
In partnership with national governments, health experts, and local communities, we build health providers’ skills,
and we develop systems that save lives now and guarantee healthier futures for women and their families. Our
aim is revolutionizing health care for the planet’s most disadvantaged people.
Jhpiego is a Johns Hopkins University affiliate.
Jhpiego Corporation
Brown’s Wharf
1615 Thames Street
Baltimore, MD 21231-3492, USA
www.jhpiego.org
© 2018 by Jhpiego Corporation. All rights reserved.
Editors: Melanie S. Curless, MPH, RN, CIC
Chandrakant S. Ruparelia, MD, MPH
Elizabeth Thompson, MHS
Polly A. Trexler, MS, CIC
Editorial assistance: Karen Kirk Design and layout: AJ Furay
Dana Lewison Young Kim
Joan Taylor Bekah Walsh
Module 1 Jhpiego technical reviewers: Neeta Bhatnagar, India
Saswati Das, India
Silvia Kelbert, USA
,Module 1: Introduction to Infection Prevention and
Control
Chapter 1. Introduction to Health Care-Associated Infections .............................................................. 3
Key Topics ................................................................................................................................................. 3
Key Terms .................................................................................................................................................. 3
Background ............................................................................................................................................... 4
Burden of Health Care-Associated Infections ........................................................................................... 4
Impact of Health Care-Associated Infections in LMIC............................................................................... 5
Microbiology of Health Care-Associated Infections ................................................................................. 5
Contributing Factors for Health Care-Associated Infections .................................................................... 6
Interventions to Prevent Health Care-Associated Infections ................................................................... 6
Summary ................................................................................................................................................. 10
References .............................................................................................................................................. 11
Chapter 2. Standard and Transmission-Based Precautions ................................................................. 13
Key Topics ............................................................................................................................................... 13
Key Terms ................................................................................................................................................ 13
Background ............................................................................................................................................. 14
Standard Precautions .............................................................................................................................. 17
Transmission-Based Precautions ............................................................................................................ 19
Summary ................................................................................................................................................. 24
Appendix 2-A. Type and Duration of Precautions Recommended for Selected Infections and
Conditions ............................................................................................................................................... 26
References .............................................................................................................................................. 36
Chapter 3. Basic Microbiology for Infection Prevention and Control ................................................... 37
Key Topics ............................................................................................................................................... 37
Key Terms ................................................................................................................................................ 37
Background ............................................................................................................................................. 39
Classification and Identification of Microorganisms............................................................................... 40
Microbial Pathogenesis—How Microbes Cause Disease ........................................................................ 47
Specimen Collection and Transport ........................................................................................................ 49
Diagnostic Approaches in Clinical Microbiology ..................................................................................... 50
Overview of Microorganisms of Interest for Infection Prevention and Control..................................... 52
Potential Microbial Agents of Bioterrorism ............................................................................................ 55
Role of the Clinical Laboratory in Infection Prevention and Control ...................................................... 56
Infection Prevention and Control: Module 1 1
, Summary ................................................................................................................................................. 57
References .............................................................................................................................................. 58
2 Infection Prevention and Control: Module 1
Health Care Facilities with Limited Resources
Infection
Prevention
and Control.
Module 1. Introduction to Infection Prevention
and Control
Authors
Melanie S. Curless, MPH, RN, CIC
LaToya A. Forrester, MPH, CIC
Polly A. Trexler, MS, CIC
,The authors have made every effort to check the accuracy of all information, the dosages of any drugs, and
instructions for use of any devices or equipment. Because the science of infection prevention and control is rapidly
advancing and the knowledge base continues to expand, readers are advised to check current product information
provided by the manufacturer of:
• Each drug, to verify the recommended dose, method of administration, and precautions for use
• Each device, instrument, or piece of equipment to verify recommendations for use and/or operating
instructions
In addition, all forms, instructions, checklists, guidelines, and examples are intended as resources to be used and
adapted to meet national and local health care settings’ needs and requirements. Finally, neither the authors,
editors, nor the Jhpiego Corporation assume liability for any injury and/or damage to persons or property arising
from this publication.
Jhpiego is a nonprofit global leader in the creation and delivery of transformative health care solutions that save lives.
In partnership with national governments, health experts, and local communities, we build health providers’ skills,
and we develop systems that save lives now and guarantee healthier futures for women and their families. Our
aim is revolutionizing health care for the planet’s most disadvantaged people.
Jhpiego is a Johns Hopkins University affiliate.
Jhpiego Corporation
Brown’s Wharf
1615 Thames Street
Baltimore, MD 21231-3492, USA
www.jhpiego.org
© 2018 by Jhpiego Corporation. All rights reserved.
Editors: Melanie S. Curless, MPH, RN, CIC
Chandrakant S. Ruparelia, MD, MPH
Elizabeth Thompson, MHS
Polly A. Trexler, MS, CIC
Editorial assistance: Karen Kirk Design and layout: AJ Furay
Dana Lewison Young Kim
Joan Taylor Bekah Walsh
Module 1 Jhpiego technical reviewers: Neeta Bhatnagar, India
Saswati Das, India
Silvia Kelbert, USA
,Module 1: Introduction to Infection Prevention and
Control
Chapter 1. Introduction to Health Care-Associated Infections .............................................................. 3
Key Topics ................................................................................................................................................. 3
Key Terms .................................................................................................................................................. 3
Background ............................................................................................................................................... 4
Burden of Health Care-Associated Infections ........................................................................................... 4
Impact of Health Care-Associated Infections in LMIC............................................................................... 5
Microbiology of Health Care-Associated Infections ................................................................................. 5
Contributing Factors for Health Care-Associated Infections .................................................................... 6
Interventions to Prevent Health Care-Associated Infections ................................................................... 6
Summary ................................................................................................................................................. 10
References .............................................................................................................................................. 11
Chapter 2. Standard and Transmission-Based Precautions ................................................................. 13
Key Topics ............................................................................................................................................... 13
Key Terms ................................................................................................................................................ 13
Background ............................................................................................................................................. 14
Standard Precautions .............................................................................................................................. 17
Transmission-Based Precautions ............................................................................................................ 19
Summary ................................................................................................................................................. 24
Appendix 2-A. Type and Duration of Precautions Recommended for Selected Infections and
Conditions ............................................................................................................................................... 26
References .............................................................................................................................................. 36
Chapter 3. Basic Microbiology for Infection Prevention and Control ................................................... 37
Key Topics ............................................................................................................................................... 37
Key Terms ................................................................................................................................................ 37
Background ............................................................................................................................................. 39
Classification and Identification of Microorganisms............................................................................... 40
Microbial Pathogenesis—How Microbes Cause Disease ........................................................................ 47
Specimen Collection and Transport ........................................................................................................ 49
Diagnostic Approaches in Clinical Microbiology ..................................................................................... 50
Overview of Microorganisms of Interest for Infection Prevention and Control..................................... 52
Potential Microbial Agents of Bioterrorism ............................................................................................ 55
Role of the Clinical Laboratory in Infection Prevention and Control ...................................................... 56
Infection Prevention and Control: Module 1 1
, Summary ................................................................................................................................................. 57
References .............................................................................................................................................. 58
2 Infection Prevention and Control: Module 1
