NOSOCOMIAL INFECTIONS

Nosocomial Infections

Nosocomial Infections

Life-History of the Infectious Agent

Hospital-acquired (nosocomial) infections are a significant concern to the health of patients requiring a hospital stay. These infections affect millions of Americans, lead to tens of thousands of deaths yearly, and cost billions of dollars. They may arise from devices, such as intravenous tubes and catheters, and often affect older and critically ill patients. There are a variety of possible causative agents (www.lasvegassun.com). Some of these pathogens have developed resistance to common treatment therapies, complicating treatment options. Many steps to minimize nosocomial infection rates have been taken, which have proved marginally successful. Proper prevention and treatment are necessary to reduce morbidity and mortality, as well as to decrease the costs of treating these preventable infections (clinicalposters.com).

When a patient presents to the hospital with signs and symptoms of an infection (nonnosocomial), it is often appropriate to initiate broad-spectrum, multidrug therapy as an initial treatment. After test results (cultures) return in a few days, the pathogen and susceptibility can be identified. Then therapy is narrowed to cover the infecting pathogen with as little antibiotic coverage outside what is necessary to treat.

Basic Characteristics

Infection can develop after contact with an infected or colonized (uninfected person carrying a pathogen) individual, which may include healthcare workers, visitors, or even other patients.

Fomites (inanimate objects that may harbor pathogens) can lead to nosocomial infections. Studies have demonstrated that Fomites such as physicians' neckties and handbags often have bacteria that can cause nosocomial infections. Researchers were able to grow bacteria after swabbing them. Although it is unusual to receive a nosocomial infection this way, it underscores the importance of maintaining strict hygienic procedures in hospitals.

Infections can be transmitted via respiratory droplets. Coughing, sneezing, or even talking closely with an infected person could lead to disease.

Many infections are directly related to invasive devices used in the hospital to monitor the patient or to provide therapy. Catheters (intravenous or bladder) and surgical drains or tubing can lead to infection. Proper sanitary technique and prompt changing/removal can reduce nosocomial infections.

Clinical Disease Caused By the Agent

Poor hand hygiene by hospital staff can lead to nosocomial infections. There has been a trend in hospitals and clinics over the past several years to install hand sanitizers outside each patient's room to make it easier to remember to wash hands after and before seeing patients.

Transmission

Fomites (inanimate objects that may harbor pathogens) can lead to nosocomial infections. Studies have demonstrated that Fomites such as physicians' neckties and handbags often have bacteria that can cause nosocomial infections. Researchers were able to grow bacteria after swabbing them. Although it is unusual to receive a nosocomial infection this way, it underscores the importance of maintaining strict hygienic procedures in hospitals. Infections can be transmitted via respiratory droplets. Coughing, sneezing, or even talking closely with an infected person could lead to disease.

Symptoms

Flu

Nausea

Headache

Complications

A number of risk factors have been identified for development of hospital-acquired infections. These include but are not limited to the following:

Mechanical ventilation

Advanced age

Immunosuppression (by either medications or disease)

Chronic disease

Recent surgery

ICU admission

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