EMERGING NOSOCOMIAL INFECTION

Emerging Nosocomial Infection

Table of Contents

I. INTRODUCTION4

II.DEFINITION4

III.EPIDEMIOLOGY4

IV.TYPES OF NOSOCOMIAL INFECTIONS5

A. NOSOCOMIAL URINARY TRACT INFECTION6

B. NOSOCOMIAL PNEUMONIA6

C.SURGICAL WOUND INFECTION6

D.NOSOCOMIAL BACTEREMIA6

E.OTHER SITE OF NOSOCOMIAL INFECTION7

F. ANTIBIOTIC RESISTANT7

a. MRSA7

b. VRE8

V. METHODS OF TRANSMISSION8

Microorganisms are transmitted in hospitals by several routes, and the same microorganism may be transmitted by more than one route. There are five main routes of transmission—contact, droplet, airborne, common vehicle, and vectorborne.8

A. CONTACT8

The most important and frequent mode of transmission of nosocomial infections, is divided into two subgroups: direct-contact transmission and indirect-contact transmission.8

a. DIRECT8

b. INDIRECT9

B. AIRBORNE9

C.VEHICLES TRANSMISSION10

D.VECTORBORNE TRANSMISSION10

VI. HIGH RISKS FACTORS10

A. AGE10

B. CHRONIC DISEASES/POOR HEALTH10

C.PROCEDURE10

D.IONIZING RADIATION11

E.ICU/PICU/NICU PATIENTS11

VII. THREE MAJOR FORCES INVOLVED IN NOSOCOMIAL INFECTIONS11

A. USE OF ANTIMICROBIALS11

B. WIDESPREAD USE OF CEPHALOSPHORINE12

C.WIDESPREAD EMPERIC USE OF VANCOMYCIN12

VIII. PREVENTIONS13

IX. NOSOCOMIAL INFECTION UPDATE13

X. REFERENCES15

Emerging Nosocomial Infection

I. INTRODUCTION

Nosocomial infections are transmitted due to the fact that hospitals house large numbers of people who are sick and whose immune systems are often in a weakened state. Increased use of outpatient treatment means that people who are hospitalized are more ill and have more weakened immune systems than may have been true in the past. (Haley, 2005) Moreover, some medical procedures bypass the body's natural protective barriers. Since medical staff move from patient to patient, the staff themselves serve as a means for spreading pathogen. (Slaughter, 2006)

II.DEFINITION

Nosocomial infections are infections which are a result of treatment in a hospital or a healthcare service unit, but secondary to the patient's original condition. Infections are considered nosocomial if they first appear 48 hours or more after hospital admission or within 30 days after discharge. Nosocomial comes from the Greek word nosokomeion (??s???µe???) meaning hospital (nosos = disease, komeo = to take care of). This type of infection is also known as a hospital-acquired infection (or more generically healthcare-associated infection). (Mann, 2005)

III.EPIDEMIOLOGY

Hospitals have sanitation protocol regarding uniforms, equipment sterilization, washing, and other preventative measures. Thorough hand washing and/or use of alcohol rubs by all medical personnel before and after each patient contact is one of the most effective ways to combat nosocomial infections. (Fridkin, 2007) More careful use of anti-microbial agents, such as antibiotics, is also considered vital. Despite sanitation protocol, patients cannot be entirely isolated from infectious agents. Furthermore, patients are often prescribed antibiotics and other anti-microbial drugs to help treat illness; this may increase the selection pressure for the emergence of resistant strains. (Voorhis, 2006)

In the United States, it has been estimated that as many as one hospital patient in ten acquires a nosocomial infection, or 2 million patients a year. Estimates of the annual cost range from $4.5 billion to $11 billion and up. Nosocomial infections contributed to 88,000 deaths in the U.S. in 1995. One third of nosocomial infections are considered preventable. Ms. magazine reports that as many as 92 percent of deaths from hospital infections could be prevented. The most common nosocomial infections are of the urinary tract, surgical site and various pneumonias

In France, prevalence in a sample of hospital patients was 6.7% in 1990, and the rate of nosocomial infections ...