Nosocomial infections pose a he alth risk to patients and are the subject of much research. It turns out that the type of nosocomial infection often depends on what department of the hospital treated the patient and what procedures were performed. What nosocomial infections are lurking in hospital wards?

Nosocomial infectionshappen all over the world. As many as 5 to 10 people out of 100 inpatients may develop an infection while in hospital. What are the most common types of infections characteristic of individual treatment wards?

Hospital infections: neurosurgery ward

Surgical site infections occur as superficial, deep (skull bone infection) and organ infections (intracranial infections). Additionally, there are infections of the valve systems, electrodes, and bone grafts. The most common causes of infections are Staphylococcus aureus, Pseudomonas, Acinetobacter and fungi.

Hospital infections: cardiac surgery department

In the cardiac surgery department, infectious complications may occur after the following procedures: in ischemic heart disease, congenital heart disease, valve implantation, pacemaker implantation. Infections also occur in procedures performed in progressive heart failure, pervalvular abscess, aneurysm.

Surgical site infections can manifest themselves as superficial, deep or organ infections. The cause are streptococci from the "orale" group - oral, enterococci, staphylococci, and among gram negative bacilli - Pseudomonas, Acinetobacter, Serratia, Enterobacter.

Hospital infections: vascular surgery department

The frequency of infections in this group of procedures is associated with operations in elderly people, people with diabetes, coronary heart disease, and respiratory failure. Many procedures are performed on vessels with primary infection of the wall of arteries, aneurysms.

The most common infections occur during the implantation procedure, as well as in the vicinity of the implant location. The causes of infections in vascular surgery are staphylococci, streptococci, Gram-negative intestinal bacilli, Pseudomonas, and fungi.

Due to ischemic changes in the operated limbs, infection with anaerobic gas gangrene should always be considered.

Hospital infections:bone surgery department

In this case, we are dealing with infections associated with the introduction of foreign bodies BAI (Biomaterial Associated Infections). In patients with implants, infections may become apparent up to 12 months from the date of surgery.

plays a major role in these infections
  • colonization of the implant with microorganisms from the patient's skin, operating room air, staff skin
  • not following the rules when putting on sterile gloves
  • use of inappropriate surgical gowns
  • opening packages with a sterile implant by a person who has not washed and disinfected their hands or broke the rules of asepsis while opening the implant

The microorganisms responsible for these infections are coagulase negative staphylococci, golden staphylococci, "orale" streptococci, entrococci, gram negative bacilli, and occasionally other bacteria.

Hospital infections: head and neck surgery department

Infectious complications after such procedures are caused by microorganisms present in the oral cavity, including anaerobic bacteria and fungi of the genus Candida, Aspergillus.

Hospital infections: gynecology ward

Infections in this group are favored by inflammatory changes in the vagina or other parts of the reproductive organ. Clinical forms of surgical site infections include: superficial surgical site (incision site) infections, deep or systemic surgical site infections, including pelvic infections.

Following cesarean delivery, inflammation of the uterine cavity, less often peritonitis, may occur. The most frequently isolated etiological factors of these infections are: E. coli, Enterobacter, Klebsiella, Gardnerella, Bacteroides fragilis, Ureaplasma, Enterococcus.

Infections after abdominal surgery

Treatments in the clean-contaminated field are relatively rarely complicated by infections (e.g. gastric surgery). On the other hand, in colorectal and rectal surgery, the surgical field is always contaminated and the probability of surgical site infection is high. The infectious microorganisms are recruited from the flora of the large intestine, i.e. gram negative, non-fermenting, intestinal rods.

Infections associated with organ transplantation

Patients undergoing organ and bone marrow transplants are the most vulnerable to infections. Infections are caused by bacteria, viruses, fungi and even parasites. The reason is the lack of defense mechanisms in this group of patients, which are destroyed by the disease and the procedure for carrying out the transplant.

The degree of threats depends on the transplanted personthe organ and its storage conditions, the recipient's reaction to the transplant, the use of invasive diagnostic and therapeutic procedures, the patient's long stay in the hospital and exposure to environmental infectious agents.

The source of infections may be the recipient's natural microbiota, recruited from gram-positive cocci, gram-negative bacilli, anaerobes and Candida fungi. They can also be CMV, the Herpes virus. Another dangerous source of infection is a transplanted organ, which can be a source of CMV, HBV, HCV, Herpes and bacteria.

Hospital infections: gynecology ward

Infections in this group are favored by inflammatory changes in the vagina or other parts of the reproductive organ. Clinical forms of surgical site infections include: superficial surgical site (incision site) infections, deep or systemic surgical site infections, including pelvic infections.

Following cesarean delivery, inflammation of the uterine cavity, less often peritonitis, may occur. The most frequently isolated etiological factors of these infections are: E. coli, Enterobacter, Klebsiella, Gardnerella, Bacteroides fragilis, Ureaplasma, Enterococcus.

Infections after abdominal surgery

Treatments in the clean-contaminated field are relatively rarely complicated by infections (e.g. gastric surgery). On the other hand, in colorectal and rectal surgery, the surgical field is always contaminated and the probability of surgical site infection is high. The infectious microorganisms are recruited from the flora of the large intestine, i.e. gram negative, non-fermenting, intestinal rods.

Infections associated with organ transplantation

Patients undergoing organ and bone marrow transplants are the most vulnerable to infections. Infections are caused by bacteria, viruses, fungi and even parasites. The reason is the lack of defense mechanisms in this group of patients, which are destroyed by the disease and the procedure for carrying out the transplant.

The degree of threats depends on the transplanted organ and its storage conditions, the recipient's response to the transplant, the use of invasive diagnostic and therapeutic procedures, long hospital stay and exposure to environmental infectious agents.

The source of the infection may be the natural flora of the recipient recruited from Gram positive cocci, Gram negative bacilli, anaerobes and Candida fungi. They can also be CMV, the Herpes virus. Another dangerous source of infection is a transplanted organ, which can be a source of CMV, HBV, HCV, Herpes and bacteria.

Category:

Infectious diseases