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Nosocomial Infection: What To Know
Nosocomial infections are infections that develop while a person is receiving medical attention. Examples include pneumonia, urinary tract infections (UTIs) and gastrointestinal (GI) infections.
The person will not have this infection on admission but may acquire it in healthcare settings such as hospitals, ambulances, and long-term care facilities.
Nosocomial infections have different symptoms, diagnoses, treatments, and potential complications.
Common types of this infection include:
This article looks at nosocomial infections in more detail, how they occur, and the types of infections. We also look at risk factors, prevention, and the outlook for these infections.
Doctors also refer to nosocomial infections as healthcare-associated infections (HAI) and hospital-acquired infections.
They are infections that people acquire while receiving healthcare, after admission. The infection can occur when a pathogen — an organism that can cause disease — spreads to a susceptible host.
According to the Centers for Disease Control and Prevention (CDC), some of the many invasive procedures and devices involved in modern healthcare can contribute to the spread of infection. These techniques and devices include:
The causes of nosocomial infections vary. They depend on the type or source of infection, the pathogen that caused it, and whether the infection is viral, fungal, or bacterial.
Nosocomial infections affect 3.2% of all hospitalized patients in the United States. Antibiotic and multidrug-resistant organisms have led to further complications and greater numbers of these infections. Because of this, there has been a major effort to detect and control them with infection prevention and control programs.
Types of nosocomial infections include:
A central line, or a central venous catheter, is a tube or catheter to administer fluids or medication or collect blood for specific medical tests. Doctors typically place it in a large vein in the:
Doctors most often use central lines in intensive care units (ICUs). They access a major vein close to the heart and can remain in place for weeks to months. This means they are more likely to cause a serious infection than other types of intravenous catheters, such as IVs.
A CLABSI is a serious infection that can occur when pathogens, such as viruses or bacteria, enter the bloodstream through the catheter.
SymptomsThe symptoms of a CLABSI vary depending on the type of infection that has entered through the catheter. Someone showing signs of infection requires immediate medical intervention. These include:
To diagnose CLABSI, a doctor will perform blood tests and check for signs of infection at the site of the catheter insertion and inflammation beyond the insertion site.
To treat CLABSI, a doctor typically removes the catheter and administers antibiotics.
They may also prescribe other appropriate medications, such as antifungal medication, depending on the type of infection. Healthcare professionals may also recommend topical or systemic antimicrobials to treat the area where the catheter enters the body.
Potential complicationsCLABSI is serious and can be fatal. The infection can cause severe sickness and increase a person's time in the hospital.
CLABSI may also lead to sepsis, an extreme response by the immune system to infection, which can damage organs and may be life threatening.
CAUTI is a UTI a person may acquire after a doctor inserts a urinary catheter. Pathogens can travel along the catheter and enter the urinary tract. The bacterium Escherichia coli is the most common cause of CAUTI.
SymptomsSymptoms of a UTI include:
Diagnosis and treatmentA doctor will diagnose CAUTI by administering a urine test. To treat it, they will remove or change the catheter and administer antibiotics.
Potential complicationsPossible complications of CAUTI include:
An SSI is an infection that occurs in the part of the body where the surgery took place. The infection can be superficial and only affect the skin, or it can be more severe and affect:
Symptoms of SSI include:
A doctor will look for visible signs of infection and perform blood tests to diagnose SSI. To treat it, they will prescribe antibiotics. A person may also require further surgery to treat the infection.
Potential complicationsSSIs can lead to life threatening conditions, such as sepsis, as well as:
VAP can occur when a person inhales contaminated material through a ventilator. Pathogens that travel through the ventilator can cause pneumonia after 48 hours of intubation. Of people requiring manual ventilation, 5–15% develop VAP.
SymptomsSymptoms of VAP include:
Diagnosis and treatmentA doctor may diagnose VAP using:
Doctors typically treat VAP with antibiotics.
Potential complicationsComplications of VAP include:
A person may acquire a bacterial infection during healthcare. These include:
Symptoms vary depending on the type of bacteria and infection that affect a patient.
They may include:
A doctor typically diagnoses bacterial infections by examining a person's physical symptoms and blood tests.
Antibiotics are generally effective treatments against bacterial infections. A doctor may use different types to treat different infections.
Potential complicationsComplications of bacterial infections include:
Nosocomial infections may also be:
Symptoms of other types of infection include:
DiagnosisA doctor will diagnose these infections by examining the physical symptoms and performing laboratory tests, including blood tests, to reveal which pathogens affect the patient.
TreatmentTreatments vary according to the type of infection.
Infection can lead to more severe infections and complications such as sepsis.
Some people are at higher risk than others of nosocomial infection. These risk factors include:
Doctors will inform people of the potential risk of developing infections when receiving care.
Medical professional workers will assess a person's risk factors for developing specific infections and provide measures to help minimize them.
Healthcare workers and patients can help prevent nosocomial infection. Preventive measures include:
The outlook for a nosocomial infection varies by its type and severity.
Researchers have not fully documented the mortality rates of these infections, which vary between sources of information.
Some studies show a 10% mortality rate, while others argue there is a 12–80% mortality rate for these infections, depending on the definitions researchers include in studies. Therefore, more research needs to determine more conclusive figures.
An international study from the above research found that people in the ICU with nosocomial infections had a 25% mortality rate. The study also found that while there was a 15% mortality rate for hospital patients overall, there was a 30% mortality rate for those with nosocomial infection.
Nosocomial infections are infections that a person may acquire while receiving healthcare. The infection is not usually present before their admittance, and the individual acquires it in a setting such as a hospital or long-term care facility.
These infections often occur with catheters, surgery, or medical device implantation. Different types of nosocomial infections can lead to different symptoms and complications. Doctors can provide a prompt diagnosis and treatment depending on the type of infection.
Deadly Diseases
The Greek physician Hippocrates described the symptoms of pneumonia 2,400 years ago. But this affliction of the lungs still kills more people in the United States than any other infectious disease, taking 40,000 to 70,000 lives each year. It is the most common lethal nosocomial, or hospital-acquired, infection.
The term "pneumonia" describes a group of symptoms that may be caused by bacteria, viruses, parasites, or fungi. Pneumonia is a severe inflammation of the lungs in which the thin tissue around air spaces called alveoli swells and fills with fluid. Symptoms include shaking, chills, a rapidly rising fever, and sharp chest pain made worse by breathing and coughing. Pneumonia is a common cause of death among elderly people and young children whose immune systems are weakened or impaired in some way.
A common bacterium, Streptococcus pneumoniae, lives in the respiratory tract of 15 percent of the population without causing problems. It can spread pneumonia only if inhaled deeply into the lungs. The germ travels via droplets conveyed through coughing, sneezing, and even talking in close proximity. Bacterial pneumonia is most common in winter and spring, when upper respiratory tract infections are frequent. Pneumonia is also a common complication of influenza.
Most cases of bacterial pneumonia can be effectively treated with penicillin. Between 1936 and 1945, pneumonia death rates in the United States dropped approximately 40 percent with the greater availability of antibiotics. The more common viral pneumonia usually diminishes on its own, but all strains of pneumonia can be serious if neglected, and people should always seek medical supervision for their care.
Along with other acute respiratory infections, pneumonia is in a near tie with diarrheal diseases as a leading cause of death in children under 5 worldwide. It's estimated that pneumonia kills approximately two million children each year, with 40 percent of these deaths in Africa. More than two-thirds of pneumonia deaths among children in the developing world are caused by just two kinds of bacteria: Pneumoccoccus and Hemophilus influenzae.
Trained community health workers can dramatically reduce these deaths when they teach parents to identify the early signs of pneumonia: rapid breathing and violent shaking in the chest. At present, as many as two-thirds of children with acute respiratory infections are not treated by trained health providers. Even the simplest understanding of how to count the number of breaths a child takes per minute can help community health workers and parents recognize pneumonia and administer antibiotics if appropriate, or seek help at a clinic or hospital.
Time is often of the essence with pneumonia: Severe pneumonia can kill victims within hours as they literally drown in the fluids flooding their lungs. In Honduras, pneumonia treatment is part of a national, integrated community child care program that trains community volunteers to monitor children's growth, provide health education, and treat pneumonia and diarrhea.
A major contributing factor to respiratory infections is indoor air pollution. We tend to think of this type of air pollution as a problem in the industrialized world, but half of the world's people rely on dung, wood, crop waste, or coal for cooking and heating. These solid fuels cause high levels of particulate matter in the developing world that are 100 times higher than concentrations in the United States or Europe. Poor ventilation of smoke makes breathing difficult and exposes young children to severe respiratory infections. Reducing indoor air pollution may require switching to cleaner and more efficient fuels such as liquid petroleum, electricity, or solar power, and the cooperation of governments. Pneumonia is also a leading cause of immediate death among AIDS patients.
Vaccines against certain kinds of pneumonia exist for adults, but many high-risk patients do not routinely receive them. A relatively new pneumococcal vaccine for children called Prevnar, introduced by Wyeth Pharmaceuticals, has proved effective in the United States, dramatically reducing disease incidence by approximately 80 percent. But the $50-per-dose U.S. Price makes it far too expensive to be widely used in the developing world. Another H Flu (Hib) vaccine has also been found to be effective in field testing. International health economists are searching for a better way to fund lifesaving vaccines than relying on the free market alone.
Return to Deadly Diseases
Watch Out For Urinary Tract Infections In Hospitals
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