Nosocomial is a term used to describe ailments that develop while patients are under medical care. Other names include hospital-associated or acquired infections. These diseases result from microorganisms acquired during a stay in healthcare facilities such as hospitals or nursing homes. They are more prevalent in patients who stay for long in hospitals resulting in serious health complications, which can lead to death. While these infections occur worldwide, they present a more significant burden in developing (10%) than in developed countries (7%) (Khan et al., 2917). This paper will describe examples of nosocomial infections, their mode of spread, consequences and prevention measures. It will also outline the financial burden medical they cause on healthcare facilities and clients.
Mode of Spread
Healthcare facilities are the points of origin and spread of nosocomial infections. They often result from sick employees or patients, non-sterile and unclean surfaces and breaches in infection control practices. Transmission usually occurs through patients, intervention procedures, healthcare workers, staff, visitors or hospital equipment. It can also occur via contaminated food and water, shared surfaces and items, or contaminated environment. Hazardous hospital waste is another potential cause of nosocomial pathogens (Khan et al., 2917). There two main ways to acquire these infections; endogenous and exogenous. The former occurs when infectious pathogens come from the body and the latter from a source within the hospital.
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The number of nosocomial infections has been increasing. Khan et al. (2017) associated this trend with the ongoing increase in antibiotic resistance resulting from excessive use and misuseof broad-spectrum antibiotics. This has led to a rise of superbugs such as Escherichia, staphylococcus and pseudomonas that persist in hospital causing hard-to-treat diseases (Khan et al., 2917). Increased use of invasive techniques and advancement in organ transplant have also contributed significantly to this trend.
Examples of Nosocomial Infections
There are 50 infection sites and 13 types of nosocomial diseases according to the CDC and National Healthcare Safety Network (CDC, 2014). These are specified based on clinical and biological criteria. The most common nosocomial ailments include gastroenteritis, meningitis, skin, respiratory, soft tissue infections, surgical wound, and urinary tract infections. Most of them are associated with invasive equipment like catheters, ventilators and intravenous-lines.
Bacteria are the most notorious causes of hospital-acquired infections. According to the CDC (2014), Escherichia coli, staphylococcus aureus and pseudomonas aeruginosa are the causes of these type of diseases. Others include enterococci, Streptococcus, Acinetobacter, Legionella, Bacillus cereus, Klebsiella pneumonia, Proteus mirabilis and Serratia marcescens . Among these, those that have multi-drug resistance are the most stubborn and dangerous. They include vancomycin-resistant enterococci, Pseudomonas aeruginosa , Clostridium difficile, methicillin-resistant Staphylococcus aureus, and Klebsiella pneumonia (Haque et al., 2018). Viruses like influenza and Respiratory Syncytial Virus, as well as, certain fungi such as aspergillus and Candida albicans also cause nosocomial infections.
Nosocomial diseases pose a significant threat to healthcare systems all over the world. They affect approximately 15% of all hospitalized patients, with the most significant burden being in developing countries (World Health Organization, 2010). They pose a big problem to healthcare, primarily when they dare caused by multi-drug resistant organisms. These infections can also lead to unforeseen health complications, which can cause disability or even death. Since they develop while patients are in hospitals, they increase the cost of treatment and prolong the stay (Hassan et al., 2015). The additional treatment and loss of productivity impose an economic burden to patients, families and hospitals.
Prevention of Nosocomial Infections
Controlling nosocomial infections requires the efforts of all stakeholders. Healthcare facilities ought to develop infection control programs customized for needs using the surveillance protocol provided by CDC. Continuous surveillance is vital as it gives data about the infections, which the hospital can use to evaluate the efficacy of treatment and make proper adjustments. Haque et al. (2018) suggest that a simple action like washing or rubbing hands with alcohol-based detergents can help prevent diseases. Besides, healthcare facilities should adhere to the provided guidelines for disinfection and sterilization of medical instruments as well as, prevention of UTI associated with catheters (Hassan et al., 2015). It is also imperative to train healthcare providers, especially nurses and insist they implement these strategies. Adopting antibiotic control policy and monitoring resistance is another way to prevent nosocomial infections.
Medical Costs
Healthcare facilities need to protect their patients from nosocomial diseases. According to WHO (2010), they can achieve this using low-cost interventions such as proper disinfection of the environment and sterilization of medical equipment. Failure to implement this and other infection prevention practices adds new health problems to patients. Hospital-acquired diseases are because of hospital mistakes and negligence, and it is not fair for patients to bear the additional financial burden. In America, it is illegal for hospitals to charge patients for this extra cost of treatment. Medicare stopped covering these costs in 2009, thus leaving the burden to the hospital.
In conclusion, nosocomial infections develop during hospital stays from person-to-person or contaminated items. The most prevalent ones include UTIs, skin, surgical wound, respiratoryand blood infections caused by Escherichia, Pseudomonas and Staphylococcus. These ailments are a significant threat to healthcare systems and economy globally. It is, therefore, paramount for hospitals to conduct surveillance and implement proper infection control practices to prevent them. From the evidence provided, nosocomial infections result from hospitals' negligence and mistakes. Patients, therefore, mustnot be burdened with additional costs for complications they did not have during admission.
References
CDC. (2014). Types of Healthcare-associated Infections | HAI | CDC. Cdc.gov. Retrieved 7 April 2020, from https://www.cdc.gov/hai/infectiontypes.html.
Haque, M., Sartelli, M., McKimm, J., & Bakar, M. A. (2018). Healthcare-associated infections–an overview. Infection and drug resistance, 11, 2321.
Hassan, K. A., Aftab, A., & Riffat, M. (2015). Nosocomial infections and their control strategies. Asian Pacific Journal of Tropical Biomedicine, (7), 505-509.
Khan, H. A., Baig, F. K., & Mehboob, R. (2017). Nosocomial infections: Epidemiology, prevention, control and surveillance. Asian Pacific Journal of Tropical Biomedicine, 7(5), 478-482.
World Health Organization. (2010). Infection prevention and control in health care: time for collaborative action (No. EM/RC57/R. 6).
