Infections that you can get at a medical facility while getting treatment for another disease are called nosocomial infections (also known as healthcare-associated infections or hospital-acquired infections, or HAIs). Usually, an HAI occurs after a medical or surgical procedure that can be mild to life-threatening. In most cases, people avoid most nosocomial infections with diligent infection prevention efforts.
Commonly, HAIs are infections that occur within 48 hours of hospital admission, three days after discharge from a surgical center or hospital, or 30 days after a surgical procedure. Furthermore, anyone who gets medical care at a hospital or surgical center may experience HAIs. However, they are more common in people with weakened immune systems. These infections occur due to bacteria, viruses, and fungi. While most nosocomial infections are avoidable, more than 500,000 people get them in the U.S. each year.
Types of Healthcare-associated Infections
These include:
- diff (Clostridioides difficile) infection – This is one of the most common HAIs, causing about 500,000 infections in the U.S. each year. People with C. diff often experience diarrhea and colitis. About 16% of people who get this infection will get another one within 1 to 8 weeks.
- Catheter-associated urinary tract infection (CAUTI) – This makes up 32% of all HAIs, and they develop due to long-term catheter use. This is a specific tube that goes from the bladder through the urethra to allow urine to drain from the body. This urine is collected into a bag outside the body.
- Central line-associated bloodstream infection (CLABSI) – This infection accounts for approximately 14% of all HAIs, and it occurs in people who need a central line (central venous catheter). Doctors often place this catheter into a vein near the heart to give medicines and take blood samples when needed.
- Methicillin-resistant Staphylococcus aureus (MRSA) – This is another common type of HAIs, and it is a staph infection resistant to some types of antibiotic medicines (such as Penicillin, Amoxicillin, and Methicillin).
- Surgical site infection (SSI) – It accounts for 22% of all diagnosed HAIs. While SSIs affect the incision wounds, they may also spread to deeper tissues, organs, and even surgical implants (including artificial joints and pacemakers).
- Ventilator-associated pneumonia (VAP) – About 15% of people with HAI develop VAP. Usually, it appears in people who need mechanical ventilation that allows germs to enter the lungs through a breathing tube.
Symptoms
Most of the time, people experience different symptoms because they depend on some factors. For example, the type and severity of the infection, age, and overall health. Check some examples below:
- Dyspnea (shortness of breath)
- Cough
- Heart palpitations
- Diarrhea
- Polyuria (increased urination)
- Painful urination (dysuria)
- Abdominal (belly) pain
- Fever and chills
- Confusion or irritability
It is recommended to see a doctor if any of the previous symptoms occur.
Causes and Risk Factors
In general, there are a lot of pathogens (germs) that cause nosocomial infections. Check the most common types below:
- Gram-negative bacteria – These bacteria can cause blood infections, pneumonia, and even meningitis.
- Clostridioides difficile (C. diff) – This is a singular form of bacteria that can cause colon inflammation and a very contagious form of diarrhea.
- Methicillin-resistant Staphylococcus aureus (MRSA) – This is a type of bacterial infection that is usually resistant to certain antibiotics.
- Hepatitis – This is a viral infection that can spread from one person to another. It negatively affects the liver.
While anyone may develop HAIs, doctors have identified some factors that may increase your risk of developing them. Examples include:
- Medical treatments that involve injections, surgery, mechanical ventilation, or catheters (drainage tubes)
- Weakened immune system, such as due to HIV infection or immunosuppressants
- Underlying health conditions (including diabetes, chronic lung, kidney, or liver disease, obesity, and malnutrition)
- Long-term stay in a hospital
- Invasive devices (including CAUTI, CLABSI, and VAP)
- Surgery
- Inadequate hand hygiene
- Contaminated equipment
What Happens if Nosocomial Infections Are Left Untreated?
People who leave nosocomial infections untreated may also experience some complications. Examples include:
- Endocarditis
- Osteomyelitis
- Abscess
- Sepsis
- Thrombophlebitis
- Slow wound healing
- Body cavity infections
- Rejection of implanted medical devices
- Urinary tract infections (UTIs)
- Empyema
- Respiratory failure
- Antimicrobial resistance
- Organ failure
- Septic shock
- Bloodstream infections
- Pneumonia
This document does not contain a complete list of complications. However, you can talk with your healthcare professional about ways to reduce the risk or prevent the previous complications.
How to Prevent Nosocomial Infections?
In general, it is not possible to prevent every single instance of HAIs. However, doctors may recommend some tips that may reduce the risk. These include:
- Regularly wash your hands with soap and warm water to prevent the spread of germs
- Do not be afraid to speak up if you have concerns
- Tell your doctor to remove the catheter if it is no longer needed
- Administer antibiotics exactly as recommended by your doctor. Otherwise, the infection may return, and it becomes more difficult to treat.
- Notice your healthcare professional about new or worsening symptoms
- Get recommended vaccinations
Diagnosis
In most cases, doctors can tell a person has HAI when they develop symptoms similar to an infection. These include skin rash or redness around an incision. Sometimes, they may perform a blood test or urine test (also called a urinalysis) to confirm or exclude a diagnosis.
Treatment
Doctors often prescribe different treatments for people with nosocomial infections because it depends on some factors. For example, the type and severity of the infection, your response to treatment, age, existing health problems, and preferences. In most cases, HAIs are treated with antibiotics, antivirals, or antifungals. Sometimes, it is difficult to treat a nosocomial infection because of antibiotic, antiviral, or antifungal resistance. It often occurs when germs evolve that these medicines cannot destroy them. While it is not always possible, the best treatment for nosocomial infections is prevention.
Frequently Asked Questions
How do nosocomial infections spread?
These infections often spread through respiratory droplets when a person sneezes or coughs. In some cases, you may get an HAI when physicians do not sterilize medical equipment properly.
When should I see my healthcare provider?
Do not hesitate to visit a doctor again if you notice the symptoms are worsening or you develop new symptoms, especially after a surgical procedure.
What are the most common nosocomial infections?
These include central line-associated bloodstream infections, catheter-associated urinary tract infections, surgical site infections, ventilator-associated pneumonia, and Clostridioides difficile infections. Ask your healthcare provider if you have any other questions.
