A nosocomial infection is defined as an infection or toxin found in a specific place, such as a hospital. Nosocomial infections are now synonymous with health-care-related infections (HAIs) and hospital-acquired illnesses. Before seeking medical attention for an HAI, the infection must not be present.
Doctors treat critical illnesses in the intensive care unit (ICU), which is where HAIs are most common. An HAI affects about one out of every ten persons hospitalized to a hospital. They are also linked to high morbidity, death, and healthcare expenses.
HAIs will become more common as medical care becomes more sophisticated and antibiotic resistance increases. Healthcare professionals can avoid HAIs in many ways. Continue reading to learn more about HAIs and what they can signify for you.
Respiratory Tract Infection (Pneumonia)
Pneumonia is a lung tissue infection. It affects the lungs’ air sacs (alveoli), which fill with germs, fluid, and inflammatory cells, impairing normal function. It can affect persons of any age, but it is more dangerous for the very young and the elderly. Hospital-acquired pneumonia affects 0.5 percent to 1.0 percent of hospitalized patients and is the leading cause of death among healthcare-associated infections.
The most prevalent causes are methicillin-resistant Staphylococcus aureus (MRSA), Pseudomonas aeruginosa, and other non-pseudomonal Gram-negative bacteria. Hospital-acquired pneumonia is predicted to lengthen hospital stay by around 8 days, with a reported mortality rate of 30 to 70%. These numbers include ventilator-associated pneumonia (VAP), which develops in intubated persons in an intensive care unit, which is clinically distinct from the hospital-acquired pneumonia of non-intubated patients.
Early-onset hospital-acquired pneumonia (less than 5 days after admission) is usually caused by Streptococcus pneumoniae, whereas late-onset (more than 5 days after admission) is usually caused by microorganisms acquired in the hospital, most commonly MRSA, P.aeruginosa, and other non-pseudomonal gram-negative bacteria. In 2012, 345 persons out of every 100,000 had one or more episodes of pneumonia, compared to 307 in 2004. Due to a global flu epidemic in 2009, this increased to 409 individuals per 100,000.
Surgical Site Infection
Surgical site infections (SSIs) are thought to account for up to 20% of all healthcare-associated illnesses. A surgical site infection affects at least 5% of people who have a surgical operation. A surgical site infection can range from a minor wound discharge within 7 to 10 days of surgery to a potentially fatal postoperative complication, such as a sternal infection after open-heart surgery.
Enterobacterales, including E. coli, Klebsiella, Salmonella, and Shigella, continued to account for the most significant proportion of causative organisms across all surgical categories in 2019/20 for both superficial SSIs (29.8 percent) and resounding or organ/space (26.2 percent). However, S. aureus contributes to a large proportion of deep or organ space SSIs (24.2 percent).
The proportion of superficial SSIs caused by Enterobacterales ranged from 10.6 percent in knee replacement surgery to 48.5 percent in large bowel surgery. The prevalence of deep and organ/space SSI varies from 10.0 percent for knee replacement to 55.7 percent for big bowel operations.
Sepsis
Sepsis is a clinical illness produced by activating the body’s immune and coagulation systems in the presence of an infection (bacteria, viruses, or fungi). Hospitalized critical care unit patients (ICU) are at high risk of acquiring sepsis.
Septic shock is a potentially fatal illness characterized by low blood pressure despite appropriate fluid replenishment, as well as organ failure and sepsis. Pneumonia, bowel perforation, urinary tract infection, and severe skin infection are the most prevalent causes of sepsis in adults.
In 2017, diarrhoeal diseases (9.2 to 15 million annual cases) and lower respiratory infections (1.8-2.8 million annually) were the significant contributors to sepsis cases and sepsis-related mortality across all ages. Noncommunicable diseases, on the other hand, are on the rise; in 2017, one-third of sepsis cases and nearly half of all sepsis-related deaths were caused by an underlying injury or chronic condition.
The most frequent noncommunicable condition complicated by sepsis was maternal diseases. Neonatal illnesses, lower respiratory infections, and diarrhoeal diseases were the leading causes of sepsis-related mortality. Although E.coli is a growing danger, Group B streptococcus is the primary cause of neonatal and maternal sepsis. These infections have shown significant resistance to treatment and are considered priority pathogens for antibiotic research and development.
Urinary Tract Infections(UTIs)
The presence and proliferation of bacteria in the urinary system causes urinary tract infections (UTIs). UTIs can cause a variety of clinical symptoms, including acute and chronic pyelonephritis (infection of the kidney and renal pelvis), cystitis (infection of the bladder), urethritis (infection of the urethra), epididymitis (infection of the epididymis), and prostatitis (infection of the prostate) (infection of the prostate gland).
Infection can spread to neighboring tissues (for example, a perinephric abscess) or the circulation. High recurrence rates and rising antibiotic resistance among uropathogens pose a significant threat to the economic burden of these illnesses.
Uncomplicated UTIs commonly affect women, children, and the elderly who are otherwise healthy.
Indwelling catheters, urinary tract anomalies, immunosuppression, or antibiotic exposure are common causes of complicated UTIs. Uropathogenic E.coli (UPEC) is the most prevalent causal agent for both simple and complex UTIs, accounting for over 75% and 65% of all UTI cases, respectively.
Other causal organisms for uncomplicated UTIs include Klebsiella pneumoniae, Staphylococcus saprophyticus, Enterococcus faecalis, group B streptococcus (GBS), Proteus mirabilis, P.aeruginosa, S.aureus, and Candida spp. Other causal agents for complicated UTIs include (in order of prevalence) Enterococcus spp., K. pneumoniae, Candida spp., S. aureus, P. mirabilis, and P.aeruginosa. Acute UTI affects up to 50% of women, and by the age of 24, nearly one-third of females will have experienced at least one episode of cystitis.
Preventing Hospital Acquired Infections
The healthcare facility is responsible for HAI prevention. Hospitals and healthcare personnel should adhere to the approved sterilization and disinfection criteria. Taking precautions to avoid HAIs can reduce your chances of developing them by 70% or more. However, due to the nature of healthcare institutions, it is hard to remove all nosocomial diseases altogether.
Some general infection control measures are as follows:
- The ICU is being screened to see if persons with HIAs need to be segregated.
- Identifying the type of isolation required to protect others or limit the risk of additional infection.
- Hand hygiene, which is washing hands before and after handling individuals in the hospital, is strictly enforced.
- Wearing protective equipment such as gloves, gowns, and face shields.
- Surfaces should be cleaned regularly.
- Make sure that rooms are well ventilated.
Your healthcare practitioner can help you lower your risk of UTIs by doing the following:
- To avoid infection, use the aseptic insertion procedure.
- Insert catheters only when necessary and remove them when no longer required.
- Only change catheters or bags as medically necessary.
- Ensure the urinary catheter is fastened above the thigh and hanging below the bladder for unrestricted urine flow.
- Maintain a closed drainage system.
Book an appointment now to answer all your queries. You can visit the top Hospitals in Pakistan through Marham by calling the Marham helpline: 0311-1222398 or by online booking facility through the website or Marham mobile app.
Frequently Asked Questions(FAQs)
1-What are the 6 common hospital-acquired infections?
Infections caused by catheters include UTIs, CLIs, surgical site infections, ventilator-associated pneumonia, hospital-acquired pneumonia, and Clostridium difficile.
2-What causes a hospital-acquired infection?
Bacteria, fungi, and viruses are transferred mostly via human touch. This includes filthy hands and medical devices like catheters and respirators. Antibiotic overuse and misuse increase HAI cases.
3-What is the most common hospital infection?
Pneumonia is the most prevalent healthcare-associated infection that causes death. The most pervasive culprits include MRSA, Pseudomonas aeruginosa, and other non-pseudomonal Gram-negative bacteria.
