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Hospital-acquired infection
A hospital-acquired infection (HAI), also known as a nosocomial infection (from the Greek nosokomeion, meaning "hospital"), is an infection that is acquired in a hospital or other healthcare facility. To encompass both hospital and non-hospital settings, it is sometimes instead called a healthcare-associated infection. Such an infection can be acquired in a hospital, nursing home, rehabilitation facility, outpatient clinic, diagnostic laboratory or other clinical settings. The term nosocomial infection is used when there is a lack of evidence that the infection was present when the patient entered the healthcare setting, thus meaning it was acquired or became problematic post-admission.
A number of dynamic processes can bring contamination into operating rooms and other areas within nosocomial settings. Infection is spread to the susceptible patient in the clinical setting by various means. Healthcare staff also spread infection, as can contaminated equipment, bed linens, or air droplets. The infection can originate from the outside environment, another infected patient, staff that may be infected, or—in some cases—the source of infection cannot be determined. In some cases the microorganism originates from the patient's own skin microbiota, becoming opportunistic after surgery or other procedures that compromise the protective skin barrier or immune system. Though the patient may have contracted the infection from their own skin, the infection is still considered nosocomial since it develops in the health care setting.
During 2002 in the United States, the Centers for Disease Control and Prevention estimated that roughly 1.7 million healthcare-associated infections occurred, from all types of microorganisms, including bacteria and fungi; such infections caused or contributed to an estimated 99,000 deaths. In Europe, where hospital surveys have been conducted, the category of gram-negative infections are estimated to account for two-thirds of the 25,000 HAI-related deaths each year. Nosocomial infections can cause severe pneumonia and infections of the urinary tract, bloodstream and other parts of the body. Many types display antimicrobial resistance, which can complicate treatment.
In the UK about 300,000 patients were affected in 2017, and this was estimated to cost the NHS about £1 billion a year.
In-dwelling catheters have recently been identified with hospital-acquired infections. To deal with this complication, procedures are used, called intravascular antimicrobial lock therapy, that can reduce infections that are unexposed to blood-borne antibiotics. Introducing antibiotics, including ethanol, into the catheter (without flushing it into the bloodstream) reduces the formation of biofilms.
Contact transmission is divided into two subgroups: direct-contact transmission and indirect-contact transmission.
Alongside reducing vectors for transmission, patient susceptibility to hospital-acquired infections needs to be considered. Factors which render patients at greater risk of infections include:
Given the association between invasive devices and hospital-acquired infections, specific terms are used to delineate such infections to allow for monitoring and prevention. Noted device-associated infections include ventilator-associated pneumonia, catheter-associated blood stream infections, catheter-associated urinary tract infections and device-associated ventriculitis. Surveillance for these infections is commonly undertaken and reported by bodies such as the European Centre for Disease Prevention and Control and Centers for Disease Control and Prevention.
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Hospital-acquired infection
A hospital-acquired infection (HAI), also known as a nosocomial infection (from the Greek nosokomeion, meaning "hospital"), is an infection that is acquired in a hospital or other healthcare facility. To encompass both hospital and non-hospital settings, it is sometimes instead called a healthcare-associated infection. Such an infection can be acquired in a hospital, nursing home, rehabilitation facility, outpatient clinic, diagnostic laboratory or other clinical settings. The term nosocomial infection is used when there is a lack of evidence that the infection was present when the patient entered the healthcare setting, thus meaning it was acquired or became problematic post-admission.
A number of dynamic processes can bring contamination into operating rooms and other areas within nosocomial settings. Infection is spread to the susceptible patient in the clinical setting by various means. Healthcare staff also spread infection, as can contaminated equipment, bed linens, or air droplets. The infection can originate from the outside environment, another infected patient, staff that may be infected, or—in some cases—the source of infection cannot be determined. In some cases the microorganism originates from the patient's own skin microbiota, becoming opportunistic after surgery or other procedures that compromise the protective skin barrier or immune system. Though the patient may have contracted the infection from their own skin, the infection is still considered nosocomial since it develops in the health care setting.
During 2002 in the United States, the Centers for Disease Control and Prevention estimated that roughly 1.7 million healthcare-associated infections occurred, from all types of microorganisms, including bacteria and fungi; such infections caused or contributed to an estimated 99,000 deaths. In Europe, where hospital surveys have been conducted, the category of gram-negative infections are estimated to account for two-thirds of the 25,000 HAI-related deaths each year. Nosocomial infections can cause severe pneumonia and infections of the urinary tract, bloodstream and other parts of the body. Many types display antimicrobial resistance, which can complicate treatment.
In the UK about 300,000 patients were affected in 2017, and this was estimated to cost the NHS about £1 billion a year.
In-dwelling catheters have recently been identified with hospital-acquired infections. To deal with this complication, procedures are used, called intravascular antimicrobial lock therapy, that can reduce infections that are unexposed to blood-borne antibiotics. Introducing antibiotics, including ethanol, into the catheter (without flushing it into the bloodstream) reduces the formation of biofilms.
Contact transmission is divided into two subgroups: direct-contact transmission and indirect-contact transmission.
Alongside reducing vectors for transmission, patient susceptibility to hospital-acquired infections needs to be considered. Factors which render patients at greater risk of infections include:
Given the association between invasive devices and hospital-acquired infections, specific terms are used to delineate such infections to allow for monitoring and prevention. Noted device-associated infections include ventilator-associated pneumonia, catheter-associated blood stream infections, catheter-associated urinary tract infections and device-associated ventriculitis. Surveillance for these infections is commonly undertaken and reported by bodies such as the European Centre for Disease Prevention and Control and Centers for Disease Control and Prevention.