Nosocomial infection also known as Hospital acquired infection (HAI) is an infection that the patient acquires when he/she is admitted to a hospital or a health care facility for any reason other than that infection. The infection should have not been present or incubating prior to the patient's being admitted to the hospital.
Sites of Nosocomial infections:
- Burns and wounds: When there is a burn injury the skin becomes more vulnerable for all kinds of infections not only nosocomial infections and this may increase the risk of sepsis and septic shock.
- Urinary tract: It is the most frequent nosocomial infection site, foley catheterization accounts for more than 50% of nosocomial urinary tract infection, that's why the catheter must be removed as soon as there is no need for it to stay to decrease the risk of infection.
- Blood stream: This is common in central line cathetarization where the nosocomial infection may happen at the skin in the site of entry of the catheter or along the path of the catheter under the skin.
- Respiratory tract: This type of nosocomial infection is most common in critically ill patients, patients in the intensive care unit (ICU) and those on ventilators (ventilator associated pneumonia). These infections are associated with high infection associated complications and pneumonia.
- Gastrointestinal tract (GIT): In children gastrointeritis is the most common nosocomial infection which is mainly caused by a virus called Rotavirus. In developed countries a bacteria called Clostridium difficle is the major cause of nosocomial gastrointeritis in adults.
- Surgical site: The more complicated the procedure is, the higher the risk of having a nosocomial infection.
Factors determining the risk of nosocomial infections:
- Duration of hospital stay: The longer the patient stays in the hospital, the higher the risk of exposure to nosocomial pathogens and the greater the chance of being infected.
- Age of the patient: Elderly and neonates are at higher risk of contracting a nosocomial infection.
- Immune status: The immune system plays a major role in fighting infections. Patients with low or suppressed immunity are at a higher risk for nosocomial infections. Conditions that suppress the immune system may include malignancy, chemotherapy, radiotherapy, steriod drugs and malnutrition.
- Procedures and interventions: Procedures such as Endoscopy and surgery increases the risk of infections.
- Hospital and care personnel: Cleanliness of the hospital and health care workers hygiene plays an important role in the transmission and spread of nosocomial infection.
- General health of the patient: The general health of the patient has a role as the presence of comorbidities increases the risk of contracting infections.