Hospital-Acquired Infections

Infections that are not present at the time of admission to a hospital and develop at least 48 hours after admission are called hospital-acquired or nosocomial infections. These infections come from other patients, hospital workers and visitors, hospital equipment, devices, or environment. They spread because of invasive procedures, improper or excess use of antibiotics, and poor infection control measures. 

Infection may be due to a bacteria, viruses, or fungi. Common nosocomial infections include urinary tract infection, pneumonia, wound infection, and blood infection. The infection may be resistant to multiple drugs, hence more difficult to treat.

WHO IS AT RISK?

• The elderly
• Very young children.
• Those who have received multiple antibiotics or have been in the hospital for a long time
• Patients undergoing invasive procedures like catheterization, central lines, mechanical ventilation (life support machine).
• Those with underlying medical conditions like kidneys problems, diabetes, malnutrition, lung disease.

HOW DO THESE INFECTIONS OCCUR?

ANTIBIOTICS:  Antibiotics prescribed to treat a particular condition may end up killing bugs in your body that are considered ‘good bugs'. These bugs help to maintain a balance between the good and bad bugs in our bodies and when they are killed off, there is an unchecked growth of the ‘bad bugs'. One example is an infection called C. diff which results in diarrhoea. Excessive and improper use of antibiotics also increases risk of resistance. 

URINARY CATHETERS: Catheters are tubes passed into the body to drain fluid. Urinary (bladder)catheter helps with the drainage of urine. When left in for too long, an infection can develop.

CENTRAL LINES: These are tubes that are connected to your body to deliver medicines into blood. They can also become a passage for germs if left in for too long or if they get contaminated.

ASSISTED RESPIRATION: Breathing machines, known as ventilators, help a person breathe by delivering air to the lungs. Sometimes, pneumonia may be caused bybacteria that get to the lungs through the ventilators.

POOR CLEANING TECHNIQUE DURING SURGERY: Surgical procedures are invasive. This means the skin barrier is broken granting access to deeper tissues. It is therefore important that the patient’s skin and surgical tools used are properly cleaned and sterilised. 

HOW CAN IT BE PREVENTED?

• Hand hygiene: Involves frequent washing of hands, use of sanitizers, etc.
• Accurate use of personal protective equipment, e.g., gowns, gloves, etc.
• Observing recommended precautions
• Appropriate disposal of waste
• Routine disinfection of surfaces, medical devices, and patient equipment
• Early removal of indwelling devices and avoid their unnecessary use
• Use of the right medication at the right dose and duration

TREATMENT 

Diagnosis of hospital-acquired infection will require treatment and likely a longer hospital stay. Tests to find out the particular bug causing the infection will be done. Treatment may include antibiotics and removal of infected devices.

CONCLUSION

Many nosocomial infections can be prevented. Protect yourself and those who are at an increased risk by wearing masks, washing your hands regularly, and decontaminating surfaces and equipment used for patient care.