I would first like to express my gratitude for my research supervisor, colleagues, peers and family whose immense and constant support has been a source of continuous guidance and inspiration.
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TABLE OF CONTENTS
ACKNOWLEDGEMENTII
DECLARATIONIII
CHAPTER 2: LITERATURE REVIEW1
Factors Nosocomials that influence the manifestation of Nosocomial infections2
Microbial agent2
Vulnerability of patients3
Diagnostic and therapeutic procedures4
Environmental factors4
Bacterial resistance5
Bacterial multidrug resistance: a race against time6
1 in 20 is concerned7
Patients are not equal to risk8
A global issue, 1.4 million victims every day8
Three bacteria account for over half of the infections9
Pathophysiology9
Predisposing components11
Potential wellbeing hazards11
Risk Factors12
Mode of transmission12
Type of Infection13
Prevention14
Specific nosocomial infection14
Respiratory14
Future Prospects17
Summary19
REFERENCES20
CHAPTER 2: LITERATURE REVIEW
In the U.S. the proportion of hospital infections from 1975 to 1995 has increased by 36%, from 7.2 per 1000 to 9.8 per 1000 patients in 1995. Clinics in the U.S. buy 5 to 15% of hospital patients and 25-50% of patients in intensive care units a nosocomial infection. According to the Institute of Medicine in Washington are hospital infections, although preventable, responsible in the U.S. in the year for deaths 44000-98000. In the U.S., nosocomial infections cost per year cause 17 to 29 billion U.S. dollars. Between 1980 and 1992, died of "infection" in the U.S. has increased by 58%. To the number of deaths that occur as a result of nosocomial infection, yet there are few studies, mostly from the U.S. In these studies it was found that about 1% of these patients die directly or indirectly to it. 2.7% of all patients admitted to hospital infections are a contributing factor in a fatal outcome, are not the actual cause of death. (Anon 2001)
The first report of nosocomial infection dated from the late 50's, and emerged as a result of serious Staphylococcus aureus infections occurring in U.S. hospitals, although since the last century there was evidence of the relationship between hand washing and puerperal infections. During the next 15 years, the Entero-bacteriaceae and Pseudomonas aeruginosa were the microorganisms that predominated, however in recent years, the nosocomial flora has changed and there have been other agents such as Candida spp., Gram negative bacilli and viruses in addition to multidrug resistant organisms. The information in Mexico is low but for years the concern has arisen, first, to make a diagnosis of the real situation of the hospital and second to use this information for decision-making at local level. (Anon 2001) There are various reports about it, in tertiary hospitals and second level, where it has been estimated that the frequency of infections is about 10%, in these studies is the most common infection of the urinary tract, followed by post-surgical infections, pneumonia and bacteremia. In pediatric hospitals the most frequent nosocomial infection is pneumonia, followed by sepsis and bacteremia, urinary tract infections and ...