Definition of Nosocomial Infections

Nosocomial infections are secondary infections that are contracted as a result of medical treatment. They are also known as "hospital acquired infections" and affect 5% of patients, or 2 million people a year. Infections that manifest within the first 48 hours of medical treatment are considered to be nosocomial infections.

Types

• The most common types of nosocomial infections are urinary tract infections (UTI), pneumonia and surgical incision site infections. UTIs are caused by the use of catheters during hospitalization. Pneumonia is transmitted person-to-person and facilitated by patient inactivity, since movement helps clear fluid from the lungs. The primary concern with nosocomial infections, regardless of type, is that they tend to be antibiotic resistant and cause more severe illness.

Risk

• Patients at highest risk of nosocomial infections are those in an Intensive Care Unit (ICU) especially the neonatal, burn or pediatric ICU. Low nurse-to-patient ratios and open beds also increase the risk of an infection. A patient's general health is important, with immunocompromised patients or those already fighting an active infection at increased chance of infection. The longer a patient is hospitalized and the more severe his condition, the higher the risk of nosocomial infection.

Transmission

• Nosocomial infections are transmitted seven ways. Direct transmission involves person-to-person contact. Indirect transmission occurs when a patient touches an infected surface or receives treatment with improperly sterilized equipment. Infections are also spread via sneezing and coughing, which is called droplet transmission. Airborne transmission relies on air movement to spread germs. Common vehicle transmission results from food, water or medical devices. When infection results from an insect or animal it is called vector transmission.

Prevention/Solution

• Preventing nosocomial infections relies on stringent quality control procedures, which includes consistent hand-washing and using gloves for both patients and care providers. Aprons should be used during medical procedures, as they have been shown to reduce the spread of infection. In addition, housekeeping services need to thoroughly clean and sanitize communal surfaces.

Symptoms

• A nosocomial infection should be suspected any time a patient develops a fever or other symptoms not typically associated with the primary complaint while under medical care. The type of treatment a patient has received for a primary complaint will often point to the type of nosocomial infection.