Hospital acquired infection: Introduction, common pathogens, types of infections, transmission, prevention and treatment

Introduction of Hospital acquired infection

Hospital acquired infection (HAI) or nosocomial infecion and  health care- associated infection (HCAI) are the  synonyms of each other. It is  an infection that acquires  in a hospital  or other health care  facility like nursing home, rehabilitation centre OPD clinic or other clinic setting.It spreads to the susceptible patient in the clinical setting by various methods.By the health care staff ,  contaminated equipment, bed linens, or air droplets. It can  also originate from the outside environment, another infected patient, staff. In some cases the microorganism originates from the patient’s own skin microbiota, becoming opportunistic after surgery or other procedures that compromise the protective skin barrier.

Common pathogens

Following microorganisms are responsible for hospital acquired infection.

Staphylococcus aureus, Methicillin resistant Staphylococcus aureus, Candida albicans, Pseudomonas aeruginosa, Acinetobacter baumannii, Stenotrophomonas maltophilia, Clostridium difficile, Escherichia coli, Mycobacterium tuberculosis, Vancomycin –resistance Enterococcus, Legionnaires’ disease.

Types of infections

It is of following types.

Hospital-acquired pneumonia

–Ventilator-associated pneumonia

Urinary tract infection

Gastroenteritis

Puerperal fever

Central line-associated blood stream infection

Note: The most common nosocomial infections are the urinary tract, surgical site and various pneumonia.

Transmission of hospital acquired infection

various route of transmission are as follows.

Contact transmission

Droplet transmission

Airborne transmission

Common vehicle transmission

Vector borne transmission

Note:

In-dwelling catheter has recently been identified with hospital acquired infections.

Prevention

Prevention is better that cure, so to follow this following methods are necessary.

Sterilization

Isolation

Hand washing

Gloves

Surface sanitation

Antimicrobial surfaces

Treatment

One-third of nosocomial infections are  preventable. The CDC report estimates 2 million people in the United States with  hospital-acquired infections, resulting in 99,000 deaths. To treat nosocomial infections are difficult due to being generally multi drug resistance (MDR) organisms.  Two of the bacteria species most likely to infect patients are methicillin-resistant Staphylococcus aureus(MRSA) and Acinetobacter baumannii. Antibiotic to treat diseases causing  MRSA only  few effective drugs are available. Acinetobacter bacteria are evolving and becoming immune to existing antibiotics. Therefore, in many cases, polymyxin-type antibacterial is using.. Another growing disease, especially prevalent in New York City hospitals, is the drug-resistant Klebsiella pneumoniae. An estimated more than 20% of the Klebsiella infections in Brooklyn hospitals are now resistant to virtually all modern antibiotics. And these supergerms are now spreading worldwide that  can cause severe pneumonia and infections of the urinary tract, bloodstream, and other parts of the body.

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