Healthcare-Associated Infections and Preventive Measures

What Are Healthcare-Associated Infections?

Healthcare-associated infections are also called nosocomial infections. These are the infections that are caught in the hospital. It is caused due to an infection or toxin existing in a particular site like a hospital or any healthcare setting. Healthcare-associated infections and hospital-acquired infections are interchangeably used with nosocomial infections. The characteristic of these HAIs is that the patient might not have had the infection before they underwent medical care. The intensive care unit (ICU), where the most critical patients are treated, is where these infections are acquired most commonly. The incidence is 1 in 10 admitted patients. They also have an association with significant morbidity, mortality, and cost of the hospital.

The HAIs cases are known to grow with more complex medical care and treatment and an increase in antibiotic resistance. Though it is common, it can still be prevented.

What Are the Commonly Occurring Healthcare-Associated Infections?

The following are the most common types of infections:

• Catheter-associated Urinary Tract Infections (CAUTIs) - This type of HAIs spread from urinary catheters used to drain urine in hospital settings.

• Surgical Site Infection -.These infections occur near or on surgical wounds. These infections can be present as simple skin infections that may or may not go deeper into tissues or organs.

• Ventilator-associated Pneumonia (VAP)- This type of HAI spread from ventilators used in the hospital to help a person breathe. The tube of ventilators can carry bacteria into the lungs and cause infection.

• Central Line-associated Bloodstream, Infection (CLABSI) - It spreads from the central line placed in the hospital settings that can carry viruses or bacteria and spread infections.

• Sepsis - It is a fatal and life-threatening medical emergency due to the body’s extreme response to severe infections acquired from hospital settings.

What Are the Signs and Symptoms of Healthcare-Associated Infections?

The specific time period for an infection to occur in cases of HAIs are as follows:

• Up to 48 hours after getting admitted to the hospital.

• Within three days of getting discharged.

• Within 30 days of undergoing an operation or surgery.

• In a hospital or healthcare facility where the patient was admitted for management of disease other than infection.

The symptoms of HAIs vary depending on the type. The patient may have the following signs and symptoms:

• Fever.

• Cough.

• Dyspnea.

• Difficulty in breathing or shortness of breath.

• Discharge from a wound.

• Headache.

• Burning sensation or irritation while urinating.

• Diarrhea.

• Nausea.

• Vomiting.

• Inflammation or rashes at the site of infection.

Patients developing symptoms during their stay in the hospital may have pain and discomfort. Most of the patients become symptomatic.

How Are Healthcare-Associated Infections Caused?

It is caused by microorganisms which can be bacteria, fungi, or viruses. The prevalence of bacterial infections is the highest and ranges to about 90 %. The hospital stay makes the patients immunocompromised, and thus, they get more prone to develop these infections.

The following are the bacteria that may cause infections:

• Staphylococcus aureus may cause blood infections.

• Escherichia coli can cause urinary tract infections.

• Enterococci may lead to the urinary tract, blood, or wound infections.

• Pseudomonas aeruginosa may lead to respiratory or kidney infections and urinary tract infections. Pseudomonas aeruginosa has the highest prevalence of 11 percent and high mortality and morbidity rates.

How Are Healthcare-Associated Infections Transmitted?

The main mode of transmission is person-to-person contact via unclean hands and medical instruments or hospital tools like catheters, respiratory machines, etc. Excessive and improper use of antibiotics may make the bacteria resistant to multiple antibiotics, leading to HAIs.

Are There Any Risk Factors for Healthcare-Associated Infections?

The major risk factor is hospital admission. Hence, proper precautions are necessary. Apart from that, the following may also cause infections:

1. Elderly, especially individuals above the age of 70 years.

2. An adjacent patient or hospital roommate is infected.

3. A prolonged period of antibiotic usage.

4. Stay in the ICU for a long period.

5. Coma patients.

6. Urinary catheter usage.

7. Patients who have experienced a shock.

8. Immunocompromised patients.

9. Injury, wound, or trauma patients.

How Can Healthcare-Associated Infections Be Diagnosed?

The main method of diagnosis depends on signs and symptoms along with their past histories, like any association with risk factors or recent hospitalization. Any infection present before hospitalization is not categorized under HAIs but is necessary to mention it to the physician so that any severity of the infection can be known. Sometimes, the physician may also ask the person to undergo a blood or urine test to diagnose the condition.

How Can Healthcare-Associated Infections Be Treated?

Most of the patients are managed conservatively. The doctor treats the patient depending on the type of infection and causative organism. Most of the time, the person will be prescribed medications, bed rest, and adequate fluid intake. The medications are decided to depend on the type of causative organism and the level of resistance to a certain antibiotic. If the cause is an external medical tool like the catheters, it will be removed. A healthy diet is also prescribed.

What Is the Prognosis of Healthcare-Associated Infections?

The prognosis is good for most of the patients with medical treatment and bed rest. But, in some cases, it can progress to serious complications which can prove to be life-threatening. Although it poses less risk in most situations, it is important to follow all the prevention measures.

How Can Healthcare-Associated Infections Be Prevented?

The healthcare facilities are responsible for first-hand preventive measures. They have to make proper guidelines for sterilization and disinfection and follow them. Proper preventive measures can prevent the infection by 70 %, but it is not practically possible to prevent 100 % of the infection.

Following are the preventive measures that can be followed:

1. ICU (intensive care unit) screening to decide on the isolation of the affected patients.

2. Proper sterilization and disinfection.

3. Wearing proper protective gear, gloves, footwear, masks, etc.

4. Hand hygiene is very important. Using sanitizers and handwashing are important.

5. Surface cleaning.

6. Well-ventilated rooms are necessary.

The risk of urinary tract infections can be minimized by the healthcare worker using the following measures:

1. Following aseptic conditions.

2. Changing catheters only when required.

3. Inserting catheters only when required and the same for removal.

4. Keeping a closed drainage system.

If a person has any concerns, they can talk to their physician.

Conclusion

Hospital-acquired infections or nosocomial infections are common but can be managed and prevented. Online medical platforms have made it easier to talk to a physician or a specialist regarding concerns about this condition or any medical issue. Ask a specialist to know more.