NOSOCOMIAL INFECTION

AMARJIT SINGHMHS1007002

INTRODUCTION

Infections that are a result of treatment in a hospital or a health care unit.

They appear 48 hours or more after hospital admission or within 30 days after discharge.

Nosocomial Infections are also known as Hospital Acquired Infections (HAI’s)

NOSOCOMIAL INFECTIONS IN DEVELOPED NATIONS

In U.S. around 1.7 million HAI’s occur each year and 99,000 people lose their lives.

In Europe around 25,000 deaths occur each year.

Overall there are about 2 million annual cases of HAI’s in developed nations.

Frequency of HAI’s in developed nations is 5-10%.

It accounts for annual cost of $4.5 - $11 billions in U.S.

NOSOCOMIAL INFECTIONS IN INDIA

In India Nosocomial Infection rate is at over 25%.

Frequency is 1 in every 4 patients admitted into the Hospital.

1/3rd of all such infections are preventable.

Responsible for more mortality than any other form of accidental death.

ANTIBIOTIC RESISTANCE

Pathogens that cause nosocomial infections have a high level of resistance to antibiotic treatments and are more difficult to treat.

Some of the major concerns are: 

Methicillin Resistant Staphylococcus Aureus (MRSA)

Vancomycin-Resistant Staphylococcus Aureus Vancomycin-Resistant Enterococci (VRE)

COMMON SOURCES OF NOSOCOMIAL INFECTION

Contaminated Air, Water, Food and Medicine.

Used Equipment and Instruments.

Soiled Linen.

Hospital Waste (Bio Medical Waste).

COMMON SITES OF NOSOCOMIAL INFECTIONS

Patients admitted in ICU’s.

Patients in Labour Room.

Patients undergoing invasive procedures.

Patients on Immuno-suppressive drugs.

Young children and Elderly patients.

RISK FACTORS CONTRIBUTING TO NOSOCOMIAL INFECTIONS

Long Hospital Stay.

Use of Indwelling Catheters.

Failure of Health-Care Worker to wash hands.

Over use of Antibiotics (Bacterial Resistance).

Mechanical Ventilation.

Intravenous Catheters.

MOST COMMON TYPES OF NOSOCOMIAL INFECTIONS

Surgical Wounds.

Urinary Tract Infections (UTI’s).

Lower Respiratory Tract Infections.

Gastroenteritis.

Meningitis.

NOSOCOMIAL INFECTION DATA GIVEN BY PGI, CHANDIGARH (2006) In Burn’s Unit -36.2% infections per 1000 patient

days.

In Renal Transplant Unit -58 patients out of 100.

Ventilated associated -30.7% per 1000 ventilator days. Pneumonia

Gynecology Department -15% of UTI’s.

9% of wound infections.

NOSOCOMIAL INFECTIONS CAUSE INCREASE IN COST

Cost of additional stay in Hospital.

Cost of drugs.

Delayed discharge.

PREVENTION OF NOSOCOMIAL INFECTIONS

Hand washing and use of gloves by medical staff.

Avoiding hand contact with exposed membranes like conjunctiva or nasal areas.

Ventilators sterilization.

Vaccinate certain patients against particular pathogens.