Nosocomial infections, also known as healthcare-associated infections (HAI), are a significant public health problem. They account for a large portion of morbidity and mortality in healthcare settings, affecting both patients and healthcare personnel.
What are nosocomial infections?
The World Health Organization (WHO) defines nosocomial infections as those acquired by a patient while attending a hospital or other healthcare facility, which were not present nor incubating at the time of admission. They also include infections contracted in the hospital but manifesting after discharge. Occupational infections of healthcare personnel are also classified in this category.
Significance of nosocomial infections
Healthcare-associated infections are the most frequent adverse events during patient hospitalization. The WHO estimates that, on average, 1 in 10 affected patients will die from a healthcare-associated infection. Therefore, they are a serious patient safety issue.
Unexpected, even catastrophic medical expenses
As an unexpected illness, treatment costs increase, as more medications (primarily antibiotics) are used, and typically the patient’s hospital stay is prolonged. This harms both private and social security institutions.
Disability as a consequence of a nosocomial infection
Suffering from a nosocomial infection can lead to temporary or permanent disability in the long term. For example, consider a nosocomial pneumonia, which can leave a patient oxygen-dependent for life. It is definitely a scenario that no one wants to face. If we add to this the multi-resistance of bacteria found in intensive care units, the outlook becomes even more bleak.
The high burden of morbidity and mortality from healthcare-associated infections led the World Health Organization to focus on their prevention and control. This interest and commitment, shared with Member States, have translated into resolutions by the World Health Assembly to prevent and control nosocomial infections.
Responsible Pathogenic Agents.
The microorganisms that cause these infections can be bacteria, viruses, parasites, and fungi. Most nosocomial infections are associated with bacteria. Within these, there are 2 main types that cause healthcare-associated infections: Gram-positive cocci such as Staphylococcus and Streptococcus; and Gram-negative bacilli (for example, Acinetobacter, Pseudomonas, Enterobacter, and Klebsiella).
Main types of healthcare-associated infections.
There are 4 main types of HAIs, all associated with invasive or surgical procedures.
- Catheter-associated urinary tract infection.
- Ventilator-associated pneumonia.
- Surgical site infection.
- Catheter-related bloodstream infection.
Nosocomial infections and hospital certification.
Within the Patient Safety Model of the General Health Council, there is a section dedicated to the Prevention and Control of Infections (PCI). This model considers this a critical system to guarantee safe and quality medical care. It covers several areas of focus, emphasizing that the health establishment must implement the necessary procedures to prevent the appearance and spread of nosocomial infections. Likewise, these actions must be aligned with current health regulations.
This is one of the longest and most complicated sections to implement, but with proper guidance, we can show your health team how to fully comply with these standards for a successful hospital certification.
Sandra Edith Mayen Ramírez.
Retired Colonel Medical Surgeon.
