Hospital Acquired Infections: Types & Prevention

Hospital-acquired infections, on the other hand, are PNS or healthcare-acquired infections (HAIs) are severe infections that patients contract while receiving medical aid within a healthcare setting. Known interchangeably as nosocomial infections, HAIs are associated with high-risk rates of morbidity and mortality, preventable. 

According to the CDC, HAIs occur in about 1 in 25 hospital admissions every year; let alone the numbers acquired in other healthcare facilities.

Symptoms of Hospital-Acquired Infections – How Can They Occur?

Around 2 million people are infected with HAIs annually, with costs exceeding over $3,700 as compared to inpatients who remain uninfected. The symptoms and prevalence rates of hospital-acquired infections vary as per the site of the body involved, the severity of the disease, and the length of time since admission. 

Urinary Tract Infections

Urinary tract infections, the most common type amongst all HAIs, affect over 32% of all hospital admissions, primarily due to indwelling catheters for long periods of time. 

Catheters are drainage tubes that are inserted into your bladder via the urethra to help collect the urine in a bag for collection and accurate measurement.

Urinary Tract HAIs contracted in the Intensive Care Unit of a hospital reported a 16% increase in occurrence rates in contrast to a decrease of around 24% in acute care facilities. 

Hospital-acquired urinary tract infections cause the same symptoms as other UTIs, but they might differ in severity due to excessive use of the catheter. Symptoms such as increased urinary frequency, urgency, urinary incontinence, dribbling, 

Central line-associated Bloodstream Catheter Infections

Bloodstream infections are the most common type of HAIs and primarily occur due to indwelling central line bloodstream catheters as seen in patients receiving dialysis treatment. Symptoms vary as per the causative organism, but sepsis (disseminated infection) requiring weeks of treatment commonly occurs. Central-line bloodstream infections saw a 50% decrease in HAIs from data analyzed between 2008 and 2014. 

Ventilator-associated Respiratory Tract Infections

HAIs transmitted through ventilators can result in pneumonia, and are thus, the second most common type of infection acquired in ICUs. The symptoms vary as per the organism involved and are usually caused due to gram-negative bacteria such as Pseudomonas aeruginosa and Acinetobacter baumannii. 

Pseudomonas aeruginosa is notorious for its characteristic greenish sputum whereas pneumonia caused by Acinetobactere is distinctive due to its primary occurrence in hospital settings. Symptoms, however, vary from fever with chills, shallow or shortness of breath, wheezing, and obstructive coughing to chest pain and fatigue.

Surgical Site Infections

Patients receiving surgery are usually susceptible to common HAIs due to invasive procedures, equipment usage, and manhandling. Surgical site infections most commonly affect the skin and are found due to a lack of sterilization techniques or poor hygiene of the surgeons and other healthcare staff. Surgical site infections usually result in cellulitis which can precipitate diabetes and prolong the time of healing.

The most common cause of surgical site infection is Methicillin-resistant Staphylococcus aureus (MRSA). MRSA carries a high contagion probability, mainly because of its resistance to antibiotics containing penicillin and its derivatives such as methicillin and amoxicillin. 

Treating MRSA can be difficult as it can spread from patient to patient as well as amongst healthcare workers in the hospital setting. According to the CDC, blood-stream infections or bacteremia caused by MRSA saw a 13% decrease from 2011 – to 2014. 

Other types of hospital-acquired infections include gastroenteritis which is commonly caused by Clostridium difficile. Hepatitis can also occur due to exposure via contaminated equipment. 

Management of Hospital-Acquired Infections – Is there Hope?

Hospital-acquired infections impose a life-threatening risk, particularly in patients who are susceptible to infections or are being treated for infections. For instance, patients with HIV are at risk of pneumonia which can result in death. Similarly, those with indwelling urinary catheters or respiratory ventilators are susceptible to infections caused by Pseudomonas aeruginosa, prevalently.

Treatment is with antibiotics in HAIs caused by bacteria, and are often administered via the intravenous route. HAIs need intense monitoring as they are usually resistant to common antibiotics and thus, quite difficult to treat. 

HAIs, however, can be treated if adequate measures are taken for preventing the worsening of the acquired infections. The prime focus is on sputum analysis, blood cultures, and urinary cultures in order to diagnose the organism and conclude the relevant antibiotic for proper treatment. Patients with MRSA infections are usually isolated in order to prevent them from exposing other patients to the risk. 

Nosocomial Infections are Preventable

Healthcare workers and the hospital are responsible for preventing HAIs primarily, and thus should implement the following preventive strategies while treating patients.

• Appropriate room ventilation, regular screening of infections, and increased cleaning frequency of the wards are equally necessary.
• Encourage appropriate hand-washing techniques to maintain hygiene before and after interacting with patients, especially those at high risk.
• Sanitize hands frequently 
• Isolating high-risk patients to prevent infecting other patients and their attendants.
• Observe protective and safe gear such as face masks, gloves, and scrubs or gowns, in order to prevent the spread of infections.
• Change or remove urinary catheters when required and empty collection bags timely. 
• Encourage usage of sterilized equipment at all costs to reduce contamination and exposure to skin infections.

Around 100,000 cases of nosocomial infections result in death, numbers which can be managed as well as prevented with appropriate hygiene methods.

The Final Verdict

Symptoms of healthcare-acquired infections might be different or more severe than those that warranted inpatient care in the first place. Signs and symptoms of HAIs might become evident either during the first 48 hours of admission or even after three days of discharge from the hospital. For those who are in recovery after a surgical operation, HAIs can even occur after the first 30 days of the procedure. 

HAIs are treatable – true – but it is necessary to exercise enthusiastic prevention methods in order to minimize any chances of a possible infection or inflammation. If you or your loved one detect any new symptoms after being admitted to a healthcare facility, reach out to your primary doctor or physician for consultation.

– Disclaimer –
This blog is for informational & educational purposes only, and does not intend to substitute any professional medical advice or consultation. For any health related concerns, please consult with your physician, or call 911.