Due to nosocomial infections, not only individual hospital departments but also entire hospitals are closed. Infection in the hospital ward can be caused not only by bacteria, but also by prions, viruses, fungi and parasites. What is a nosocomial infection? What are the causes of nosocomial infections?

Nosocomial infectionis an infection that occurred in a hospital, or revealed itself during hospitalization (at least 48 hours after admission) or after the patient's discharge, and its cause is an epidemiologically documented factor pathogenic originating from another patient or hospital staff or by an endogenous microbiological factor - writes Elżbieta Narolska-Wierczewska in her work and adds: hospital infections may occur constantly with the frequency characteristic of the department (endemia) or appear rapidly as an outbreak (epidemic).

It also turns out that typical hospital infections - exogenous, i.e. cross-contamination, have their source in the transmission of an infectious agent to the patient from another patient, from staff or from the hospital environment. Endogenous nosocomial infections are caused by the patient's own microflora (pathological or opportunistic).

Hospital infections: environmental causes

According to Elżbieta Narolska-Wierczewska, the potential causes of environmental nosocomial infections are:

  • dirty hands of staff
  • contaminated staff clothing
  • non-sterile medical equipment
  • uncontaminated non-medical equipment and contaminated patient surroundings
  • improper cleaning

In the European Union there are 2.5 million hospital infections every year, which cause up to 90 thousand. deaths - according to a report published by "Plos Medicine".

  • improper division of labor: engaging unprepared people, especially in special situations, "borrowing" personnel from other departments, lack of procedures and standards
  • poor working conditions: too much workload, excessive workload, introduction of new requirements without training and training
  • admitting patients who require special conditions of hospitalization without the possibility of ensuring these conditions
  • poor sanitary and hygienic conditions of institutions, lack of procedures and standards
  • no infection control systemin the facility: no procedures and standards, no specialists

Hospital infections: sources

  • vectors (he althy and healers)
  • hospital staff
  • hospital equipment inadequately sterilized and disinfected (diagnostic equipment, surgical and treatment instruments, dressings)

The most common nosocomial infections in the EU are urinary tract infections, postoperative wounds and pneumonia. Each of them accounts for 20 percent. of all such infections.

  • personal items - underwear, clothing, bedding, hospital shoes, mattresses, blankets, pillows
  • hospital items - beds, furniture, door handles, toilets, potties, ducks, pools, bathtubs, bottles, soap dishes
  • medications - blood, plasma, eye drops, disinfectants used to disinfect wounds
  • food and water

Factors increasing the risk of nosocomial infection

  • immunosuppression
  • immunodeficiency
  • comorbidities, e.g. diabetes
  • age: children up to 1 year old, especially: prematurity, the elderly
  • long-term use of antibiotics
  • invasive diagnostic, treatment and care procedures - peripheral and central vascular catheters, urinary catheter, parenteral nutrition, endoscopy

The vast majority of nosocomial infections are associated with invasive procedures, such as the use of catheters inserted into the blood vessels and urinary tract, and mechanical lung ventilation.

  • disruption of tissue continuity: surgical procedures, burns
  • long-term or multiple hospitalizations: colonization of the digestive and respiratory systems with hospital strains
  • stay in the orphanage
  • limitation of microbiological diagnostics
  • limitation of the number of ordered tests
  • abuse of broad-spectrum antibiotics in empirical therapy - cephalosporin gen. 3
  • drug use without indications - viral infections
  • too short therapy time
  • limiting the use of targeted therapy
  • Nosocomial infection: antibiotic resistant superbugs. Infections in hospital treatment and symptoms
  • How do I get compensation for a nosocomial infection before the committee?
  • Hospital infections - material liability of the hospital and the doctor in the event of infections

When writing this text, I used the work "Hospital infections - a medical, legal, economic and ethical problem" by Elżbieta Narolska-Wierczewska from the Department of Antepidemic Supervision of the WSSE inBydgoszcz

Category:

Infectious diseases