NOSOCOMIAL INFECTION

Ridha Wahyutomo
Dept. Clinical Microbiology
 INTRODUCTION

Nosocomial infection comes from

Greek words nosus meaning
disease and komeion
meaning to take care of

Also called as HOSPITAL

ACQUIRED INFECTION

Infections are considered

nosocomial if they first appear
48hrs or more after hospital
admission or within 30 days after
discharge.
 Rise in nosocomial infection as a result of
four factor
Crowded hospital
conditions

New microorganism

Increasing number of
people with compromised
immune system

Increasing Bacterial
resistance
 EPIDEMIOLOGY
Nosocomial infections can be
exogenous (external organism) and
endogenous (opportunist normal flora)

Host susceptibility Is an important

factor in the development of
nosocomial infection.

Medical equipments and procedures

(surgery) are often responsible for
infections
 MODES OF TRANSMISSION

There are five main modes of transmission

Contact

Vector borne

Air borne

Droplet

Common vehicle
DROPLET TRANSMISSION
Droplet generated by sneezing
Coughing or respiratory tract procedures
like Broncoscopy or suction

VECTOR TRANSMISSION
Transmitted through insects and
Other invertebrates animals
such as mosquitoes and fleas.
AIR BORNE TRANSMISSION
Tiny droplet nuclei that remain (<5)
suspended in air.

COMMON VEHICLE TRANSMISSION

Transmitted indirectly by materials
contaminated with the infections.
CONTACT TRANSMISSION
Most important and frequent mode of
transmission of nosocomial infections, is divided
into two subgroups:
Direct-contact transmission
Indirect-contact transmission.

Direct-contact transmission
Involves a direct body surface-to-body surface
contact and physical transfer of microorganisms
between a susceptible host and an infected or
colonized person, such as occurs when a
person turns a patient, gives a patient a bath
 Indirect-contact transmission
Involves contact of a susceptible host with a
contaminated intermediate object, usually
inanimate, such as contaminated instruments,
needles, or dressings, or contaminated gloves
that are not changed between patients
AGENTS OF NOSOCOMIAL INFECTIONS

VIRUS

BACTERIA
FUNGI
COMMON SITES OF INFECTION
 COMMON INFECTIONS
Following are the most common nosocomial infections:
Urinary tract infection

Catheter associated infection

Pneumonia

Blood stream infections

PROBLEMS OF NOSOCOMIAL INFECTIONS

Nosocomial infections will become

more important as public health
problems as it causes,

Nosocomial suffering
Prolonged hospital stay
Increase the cost of care
significantly
 SURGICAL SITE INFECTIONS
They are also frequent

The definition is mainly clinical

(purulent discharge around wounds
or the insertion site of drain, or
spreading cellulites from wounds)

The infections can be exogenously

or endogenously
 NOSOCOMIAL PNEUMONIA
The most important are patients
on ventilators in ICU.
Recent and progressive
radiological opacities of the
pulmonary parenchyma,
purulent sputum and recent
onsite fever.
Most commonly caused by acinetobacter.
 NOSOCOMIAL BACTERAEMIA
The incidence is increasing
particularly for certain organisms
such as multi resistance coagulase
negative staphylococcus and candida.

Infections may occurs at the skin

entry site of the IV device or in the
sub cutaneous path of catheter.
 URINARY TRACT INFECTIONS
It is the most common cause of
nosocomial infections

80% of the infections are associated

with indwelling catheters.
 PREVENTION AND CONTROL

Prevention and control of nosocomial

infections can be done by the following ways,

ISOLATION
Designed to prevent transmission of
microorganisms by common routes in
hospitals. Because agent and host factors
are more difficult to control, interruption of
transfer of microorganisms is directed
primarily at transmission.
Sterilization
Sterilization of all reusable equipments
such as ventilator, humidifier and
any device that come in contact
with the respiratory tract.
Wear Gloves
They re worn for two reasons:

Provide a protective barrier and prevent

contamination of hands

Reduce the liklihood that microorganism

present on the
hands will be transmitted to the
patients during invasive and
other patient care procedure.
 Tell your doctor everything
All symptoms

Previous disease

Other alternative treatment

Other over the counter

medication
 Wear Aprons

Wearing an apron during patient

care reduces the risk of infections.

Apron is must for preventing

yourself from getting disease.
Get educated
Learn about your conditions and
treatment is the best way to
prevent an error.

Get involved
Be assertive about your rights
To be a part of the decision
Process for your medical care
CONCLUSION
There is no official national approach and no real
managerial support from authorities for nosocomial
infection

Only thing is proper asepsis, proper hand washing and

sterilization.