Nosocomial infections: symptoms, causes and treatment

What is a nosocomial infection?

Nosocomial infection is a type of infection that spreads in hospitals and other health care facilities. In the medical world, this condition is also referred to as health-care associated infection (Hi) or hospital-acquired infections.

An infection can be classified as nosocomial if transmission occurs in a hospital. Nosocomial infections also show symptoms only when the patient is discharged from the hospital. In addition, the workers in the hospital are also very likely to become infected.

Nosocomial infections are conditions caused by viruses, bacteria, and parasites or fungi.

Many factors can trigger a person to be infected in the hospital. Some of these include low immunity, the use of technology and medical procedures that increase the risk of infection, and the spread of drug-resistant bacteria among people in hospitals.

Some of the most common types of nosocomial infections in hospitals are:

• Bloodstream infections
• Urinary tract infection
• Surgical wound infection
• Pneumonia

How common are nosocomial infections?

According to data from the World Health Organization, an average of 8.7% of patients hospitalized had nosocomial infections. This means that there are about 1.4 million people in the world who get infections from hospitals.

Health workers who directly handle infected patients such as doctors and nurses are also at high risk of developing this disease.

Meanwhile, a study from Asian Pacific Journal of Tropical Biomedicine shows that there are approximately 7% of cases of hospital infection in developed countries and 10% in developing countries.

Nosocomial infection is one of the medical conditions that causes the most deaths in the world.

However, along with the development of science and health, now is the case hospital acquired infection can be overcome and prevented properly.

Signs and symptoms of nosocomial infection

Nosocomial infection is a condition that may show a variety of symptoms, depending on the type of infection that is attacking and the main cause.

However, usually an infection from the hospital has common signs and symptoms, such as:

• Fever
• Heartbeat faster than normal (arrhythmia)
• Breath faster and shorter (tachypnea)
• Skin irritation or rash
• General discomfort and pain
• Removing fluid, such as pus
• The area of ​​infection is swollen

Based on the type of infection, the following are some of the possible symptoms of nosocomial infection:

1. Bloodstream infection

Hospital infections related to bloodstream infections show the following symptoms:

• Fever
• The body shivered
• Very low body temperature
• Urinating less frequently than usual
• The pulse is faster
• Breath faster
• Diarrhea
• Nausea
• Gag

2. Pneumonia

If the nosocomial infection is associated with pneumonia, the signs and symptoms that can be felt are as follows:

• Fever
• Cough accompanied by phlegm
• Wheezing (wheezing, wheezing sound)
• Creaking sound while breathing
• Excessive sweating
• Breath shorter and faster
• Stabbing pain in the chest when breathing in or coughing
• Loss of appetite
• Limp body
• Nausea and vomiting
• Confusion, especially in elderly patients

3. Urinary tract infection

Urinary tract infections can also be associated with infection in the hospital. Symptoms of a urinary tract infection include:

• Want to urinate constantly
• Burning sensation when urinating
• Urinating frequently, but the amount of urine is small
• The urine looks frothy
• Urine is red, pink, or brown like cola
• Smelly urine
• Pain in the pelvis in women

4. Surgical wound infection

If the nosocomial infection is related to the surgical wound, the signs and symptoms that will appear are:

• Fluid or pus appears from the wound
• The wound smells bad
• Fever
• The body shivered
• The wound feels warm to the touch
• Redness of the area around the wound
• Aches and pains to the touch

You can be said to have a nosocomial infection if you are referred to a hospital and infected with a disease you never had before. The infection usually appears until:

• 48 hours after admission
• 3 days after being discharged from the hospital
• 30 days after surgery
• In a health care facility when a patient is referred for reasons other than infection.

Sometimes, there are other signs or symptoms that may not be listed above.

If you feel anxious about a symptom or feel the symptoms that have been mentioned earlier, immediately consult a doctor.

When to go to the doctor

If you have signs or symptoms hospital acquired infection as above, consult your doctor for the best solution.

Causes of nosocomial infection

Nosocomial infection is a condition caused by the spread of viruses, bacteria, or fungi throughout the patient's body.

This transmission can occur as a result of medical procedures, contact between patients, or from inserting a medical device into the body.

Most patients in the hospital have a weak immune system, so infections are prone to occur.

The most common types are bloodstream infections, pneumonia (for example: pneumonia related to ventilators), urinary tract infections, and surgery site infections.

Here are three disease-causing germs (pathogens) that most commonly cause nosocomial infections:

1. Bacteria

Bacteria are the main pathogens found in most cases of nosocomial infections. Some bacteria occur naturally in the patient's body, then infection occurs because the patient's immune system decreases.

The type of Acinetobacter bacteria is most often found in infections in the ICU. In addition, there is also Bacteroides fragilis, which is commonly found in infections of the intestinal tract or large intestine.

Bacteria such as Enterobacteriaceae, S. aureus, and C. difficile also found in hospital infections.

2. Viruses

Apart from bacteria, viruses are also among the main causes of nosocomial infections. As many as 5% of hospital infections are caused by viruses. Transmission can be through breathing, hand contact, mouth and feces.

One of the chronic diseases caused by viruses is hepatitis. Hepatitis is usually transmitted through unsterile needles.

In addition, viruses such as influenza, HIV, rotavirus, and herpes-simplex virus are also found in hospital infections.

3. Fungal parasites

People with immune system disorders are also susceptible to infection by fungal parasites in hospitals. The most common types of fungal parasites are Aspergillus sp., Candida albicans, and Cyptococcus neoformans.

Types of nosocomial infections

Meanwhile, when viewed based on the type of infection, the following are some of the causes of infection that transmission occurs in hospitals:

1. Bloodstream infection

Central line-associated bloodstream infection or bloodstream infection is the most dangerous type of nosocomial infection, with a mortality rate of 12-25%.

This bloodstream infection is usually caused by the use of an instrument that is inserted into the body, such as a catheter or intravascular device. The bacteria that may be able to trigger this infection are Staphylococcus, Enterococcus, and various types of Candida fungi.

2. Urinary tract infection

This infection is the most common type of nosocomial. As many as 12% of cases of nosocomial infections are associated with this condition. Urinary tract infections can be caused by the microflora present in the patient's body.

Patients who have a urine catheter in their body are prone to this condition.

The catheter has the potential to block the flow of urine, resulting in an infection in the bladder. The bacteria that are often found are E. coli, C. albican, and P. aeruginosa.

3. Pneumonia

Another disease associated with nosocomial infections is pneumonia. This condition is usually found in 9-27% of patients who use ventilator devices in the ICU.

Microorganisms usually attack the stomach, respiratory tract, and bronchitis, resulting in infection of the lungs.

Pathogens that are commonly found in pneumonia type infections are P. aeruginosa, S. aureus, and Haemophilus influenzae.

4. Surgical wound infection

This condition also often occurs in patients undergoing surgical procedures in the hospital. Infection can be transmitted exogenously (through air, medical equipment, and medical staff) or endogenously (from flora in the body).

Other factors that may cause infection during a surgical procedure are surgical technique, cleanliness of medical equipment, and the condition of the patient's immune system.

The three most common types of pathogens found in patients with surgical wound infections are P. aeruginosa, S aureus, and coagulation-negative Staphylococcus.

Risk factors

Nosocomial infection is a condition that may affect anyone who is undergoing treatment or after visiting the hospital.

However, there are several factors that can increase your risk of getting this infection.

The following are risk factors for developing an infection in a hospital setting:

1. Age

Nosocomial infection is a disease that generally affects patients over 70 years of age, although in some cases this infection is also found in younger patients.

2. Immune system

The body of a patient with a problematic immune system is more susceptible to infection in the hospital setting.

3. The disease suffered

Patients with diseases that affect the immune system, such as leukemia, tumors, diabetes mellitus, and AIDS are at high risk for infection in the hospital.

4. Was in the ICU long enough

Hospital patients who stay longer than regular patients, such as ICU patients, are more prone to infection in the hospital.

5. Inadequate medical facilities

Health care centers with facilities that are not up to standard can increase a patient's risk of infection, such as:

• Incorrect injection technique
• Hospital waste disposal is not properly managed
• Less sterile medical equipment

6. Use of antibiotics

Consuming too many antibiotics, not according to a doctor's prescription, or stopping before they run out can cause the body to become resistant to antibiotics. This makes it easier for hospital infections to occur.

By reducing or avoiding the risk factors above, your chances of contracting a nosocomial infection can be minimized.

Diagnosis

To diagnose nosocomial infections, doctors will usually ask what signs and symptoms are being experienced, and when the patient was last in a hospital or medical service center.

In some cases, doctors can diagnose nosocomial infections by looking at the site of infection through visible signs. In other cases, urine and blood tests, or even imaging tests are usually needed.

1. Blood test

If the doctor suspects an infection, usually a blood test is necessary. The doctor will perform a blood culture test to check for microorganism infections such as bacteria, viruses, or fungi.

This test usually aims to diagnose nosocomial infections that attack the bloodstream.

2. Urine test

If the doctor suspects that the type of nosocomial infection is a urinary tract infection, the doctor will take a sample of your urine and examine it in the laboratory.

3. Imaging tests

Sometimes, doctors will also perform tests, such as x-rays, CT scans, and MRIs, to detect any infection in the body.

Treatment of nosocomial infections

The information described is not a substitute for medical advice. ALWAYS consult your doctor.

Nosocomial infection is a condition that consists of various types and causes. Therefore, the treatment that will be recommended by the doctor is different for each patient depending on what caused it.

In most cases, antibiotics will be useful in fighting the infection. However, for cases of infection where the cause is not certain, the doctor will prescribe antibiotics that can fight almost all types of bacteria, such as pseudomona.

The doctor may also give antifungal therapy in addition to antibiotic treatment, such as

• Fluconazole
• Caspofungin
• Voriconazole
• Amphotericin B

In addition, to fight infections caused by viruses, your doctor may prescribe antiviral therapy, such as acyclovir and ganciclovir.

If a nosocomial infection occurs in a catheter or other tube inserted in the body, the doctor will remove the tube as soon as possible.

Although nosocomial infections are often thought to be treatable, some can be deadly or resistant to drugs. Health care facilities are required to check your condition regularly during your stay in the hospital.

The following lifestyle and home remedies may help treat nosocomial infections:

• Maintain cleanliness while staying in the hospital.
• Sterilize medical equipment carefully between uses.

If you have any questions, consult your doctor to better understand the best solution for you.

Home remedies

The following lifestyle and home remedies may help treat nosocomial infections:

• Maintain cleanliness while staying in the hospital. About 40 percent of nosocomial infections are caused by poor hand hygiene according to a WHO report.
• Sterilize medical equipment carefully between uses. Health care providers are also obliged to follow proper procedures.

If you have any questions, consult your doctor to better understand the best solution for you.