Prevent Nosocomial Infections

Laminated Poster

A nosocomial infection is one that develops at least 48 to 72 hours after hospitalization.

HEALTH Perhaps you remember the 1950's and 60's when physicians still made house calls and they were more inclined to admit patients with recondite illnesses to a hospital "for observation" and testing.

Now, many medical procedures are handled on an outpatient basis or with an overnight hospital stay. Perhaps patients should not become sore about any perceived diminished attention. It turns out that the "good ol' days" of healthcare may not be so good today.

Does the hospital make you sick?

Apparently lengthy stays increase a patient's chances for contracting hospital-associated, or nosocomial (nos-uh-KOH-mee-uhl), infections. This is partly due to lack of proper hygiene such as irregular bathing and toothbrushing, contact with bedpans, potential bed sores, and the absence of probiotics following antibiotic treatment. But even if hygiene is properly cared for, many other ways to contract nosocomial infections remain.

Corresponding to the increased use of invasive procedures, 5 to 8 percent of patients now acquire nosocomial infections. About 80 percent of these cases are urinary-tract infection from indwelling urethral catheters. Surgical-wound infection, pneumonia, and bloodstream infection follow in frequency. Finally, patients may acquire tuberculosis or chicken pox from other patients. [1]

The Centers for Disease Control and Prevention (CDC) estimates roughly 1.7 million hospital-associated infections, from all types of bacteria combined, cause or contribute to 99,000 deaths each year. [2] The United States healthcare system pays an estimated annual tab of $4.5 billion as a direct result of nosocomial infection. In England, the cost for one health unit is estimated to be 3.6 million pounds per year. Prolonged stay necessitated by nosocomial infection limits access of other patients to hospital resources, and contributes to overcrowding on wards and in emergency departments. Nosocomial infections also contribute to the emergence and dissemination of antimicrobial-resistant organisms. [1]

One such antimicrobial-resistant organism is called Acinetobacter baumannii. "This germ is one in a category that by some estimates are already killing tens of thousands of hospital patients each year." The New York Times continues, "While the organisms do not receive as much attention as the one known as MRSA — for methicillin-resistant Staphylococcus aureus — some infectious-disease specialists say they could emerge as a bigger threat." The pharmaceuticals industry is pursuing very few drugs for Acinetobacter and other organisms of its type (Gram-negative bacteria). [3]

Control and Prevention

Prevention of nosocomial infections requires a systematic, multidisciplinary approach. This is usually achieved under the leadership of an institutional infection-control program. Dr. Alphoso Torres Cook is head of infection control at Pacific Hospital of Long Beach. View his aggressive superbug fighting techniques in the Emmy Award winning Fox11 News report video sidebar. Among other measures, Pacific Hospital has adopted the practice of administering probiotics (yogurt) following antibiotic treatment. The principle activities of an effective nosocomial infection prevention program include surveillance, outbreak management, policy development, expert advice, and education. An optimal program may decrease the incidence of nosocomial infections by 30 to 50 percent. [1] Even surgical procedures may be modified to include non-blood medical management, MIS smaller incisions with laparoscopy or laser. This reduces the potential area of infection and the recovery time.

Improved institutional policies and practices must be implemented and followed riggorously. In particular, optimal handwashing and glove use must be facilitated and reinforced, as transmission of organisms between patients occurs primarily on the hands of staff members. Isolation guidelines to identify and segregate patients who have an increased risk of transmitting infection to other patients or staff are also essential. Many national or local standards and regulations cover hospital construction, municipal water supply, laundry management, food handling, waste disposal, sterilization and other reprocessing procedures, as well as standards for pharmacy and microbiology laboratory practice. [1]

Practical things that can be done to minimize bacterial infection even outside of hospitals include good hygiene, regular bathing and handwashing. Keep cuts and scrapes clean, dry and covered with a bandage. Apply an antibacterial ointment like Neosporin to hasten healing of small sores. Avoid any tendency to pull scabs or scratch lesions. See a physician for sores that do not heal properly or that inexplicably occur spontaneously.

Tags: epidemiology, dermatology, disease, germs, necrotizing fasciitis, staph infection

  1. Nosocomial Infections, Lindsay E. Nicolle,
  2. Nosocomial Infection, Wikipedia
  3. Rising Threat of Infections Unfazed by Antibiotics, Andrew Pollack,