What Are Hospital-Acquired Infections?
Hospital-acquired infections, also called healthcare-associated infections or nosocomial infections, are acquired from a healthcare setting like a hospital or healthcare staff like doctors or nurses. These infections can affect various systems like the lungs, urinary system, digestive system, or skin. These infections are comparatively difficult to treat and can remain longer. In some cases, they might also be fatal.
Often these infections are caused by multidrug-resistant pathogens through invasive procedures, improper use of antibiotics, and not following infection control and prevention procedures. However, in many cases, these infections are preventable by following the proper guidelines laid by the centers such as the Centers for Disease Control and Prevention (CDC).
Who Can Get Hospital-Acquired Infections?
The risk of acquiring hospital-acquired infection depends on various factors, such as the duration of hospitalization, the use of antibiotics, and the number of invasive devices and procedures used, like central venous catheters, surgical procedures, urinary catheters, and mechanical ventilation. Apart from these, it will also depend on other morbid conditions in the patients, like diabetes, renal problems, lung diseases, or malnutrition.
What Are the Types of Hospital Acquired Infections?
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Methicillin-Resistant Staphylococcus Aureus (MRSA)- They cause infection by entering the bloodstream through a catheter or medical tube.
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Catheter-Associated Urinary Tract Infections (CAUTI)- This is when the patient gets infected with the urinary catheter.
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Surgical Site Infections (SSI)- They can occur in or around the surgical wound.They can either result in simple skin infection or cause infection of deeper tissues and the organs near the wound.
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Ventilator-Associated Pneumonia (VAP)- VAP can occur in a patient on a mechanical ventilator. It is used to assist in breathing through tubes inserted in the mouth, nose, or throat for those who cannot breathe alone. The germs can directly enter the lungs through the tubes and cause infection.
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Clostridium Difficile Infections (CDIs)- This infection can result in long-lasting diarrhea. Older people on long-term antibiotics and using other medical services are at risk.
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Sepsis- It is the extreme response of the body towards an infection. This is a life-threatening medical emergency. If not attended to immediately, it can even result in the patient's death. This can happen when an existing infection simultaneously triggers a chain of infections.
What Is the Most Common Type of Hospital Acquired Infection?
Many bacteria, viruses, and fungi cause hospital-acquired infections, but the most commonly infecting is the bacterium Staphylococcus aureus. Other infectious bacteria are found in the mucous lining and the skin: Escherichia coli, Enterococci, and Candida. But bacteria like methicillin-resistant Staphylococcus aureus (MRSA) can be difficult to treat and dangerous as they are resistant to a wide range of antibiotics.
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Urinary Catheters:
A urinary catheter is a tube inserted into the bladder to collect urine outside the body in a urine bag. These catheters will help patients who have problems emptying the bladder or controlling their instincts. They are placed in patients under general anesthesia for the surgery as they are unable to control their bladder, and they will also keep the bladder empty. The most common infection is the urinary tract infection, which can happen when the pathogen spreads through the patient's perineum or a contaminated urinary catheter. These symptoms are painful urination, fever, and lower abdominal pain.
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Surgical Procedures:
The common hospital-acquired infection is at the site of the surgical wound. The factors that can cause this infection are the procedure's length and the operating room's sterility. These types of infections are caused by pathogens already present on the skin or pathogens spread by the operating room staff. They can result in skin tenderness, and drainage from the surgical sites.
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Central Venous Catheters:
They are tubes placed in the large vein located in the neck, arm, chest, or groin and remain there indefinitely. These catheters are used to give intravenous therapies like the TPN (total parenteral nutrition), which provides nutrients and fluid to the patients. The infection can be attained when puncturing the skin to insert the hubs of the central lines. This is the common hospital-acquired infection after the infections obtained from urinary catheters and surgical wound infections. This infection has the highest rate of mortality. The symptoms of infection are tenderness, skin redness, and drainage at the injection site.
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Mechanical Ventilation:
The infection acquired through a mechanical ventilator is ventilator-associated pneumonia from the contaminated oropharyngeal flora. It is the third most common hospital-acquired infection, along with central line catheter infection. Early onset nosocomial pneumonia is caused by the pathogens like Staphylococcus aureus, Streptococcus pneumoniae, and Haemophilus influenzae and can occur as early as within four days of admission. At the same time, late-onset pneumonia is caused by multi-drug-resistant bacteria like Pseudomonas aeruginosa, MRSA (methicillin-resistant Staphylococcus aureus), Klebsiella, and Acinetobacter. The signs and symptoms of nosocomial infection acquired through a mechanical ventilator are increased white blood cell count, increased mucus production, and abnormal chest X-ray findings.
How Can Hospital Acquired Infections Be Prevented?
The hospital plays an important role in preventing hospital-acquired infection. It depends on the precautionary protocol adopted by the hospital to prevent the endogenous and exogenous spread of such infections. The transmission can be through exogenous and endogenous ways. The exogenous spread is through person-to-person transmission through interaction and also through cross-contamination. The most important preventive measure to limit the spread of the infection to be adopted is following proper and frequent hand hygiene. Apart from that, proper use of personal protective equipment should be followed.
Also, healthcare workers should only use appropriate indwelling devices and remove them as soon as their requirement is over. Also, proper measures should be taken for asepsis and sterilization during insertion, removal, or maintenance of any invasive devices to avoid the environmental spread of infections. Routine disinfection of surfaces, patient equipment, and medical devices and proper waste management are also important in preventing the exogenous spread of hospital-acquired infections.
The endogenous spread of nosocomial infection occurs through inappropriate and excessive use of broad-spectrum antibiotics. This type of transmission can also happen from one part of the body to the other part within the same individual. Also, they can affect when the patient is immunosuppressed or due to other factors like malnourishment or certain medication like chemotherapy. The endogenous spread of infection can be controlled by using antimicrobials in the correct dose, agent, and duration.
Conclusion
Even though people go to the hospitals for treatment, certain diseases can be contracted from the hospital. Many factors can make a person susceptible to these infections. The healthcare workers who spend the maximum time there are the most prone people to get these infections. One can take the precautions mentioned above to prevent getting infected with them.
