In order to understand what a nosocomial infection means, the layman must first consider the meaning of the word from ancient Greek. “Nosos” means “disease” and “komein” means “to care for” and the word “Nosokomeion” stands for the ancient Greek premises of sanatoriums. A nosocomial infection therefore means nothing more than a hospital infection .
What is nosocomial infection?
Nosocomial infections are an increasing problem in hospitals and care facilities and account for the majority of all serious complications there. See aviationopedia for HMS Explanations.
The quality of nursing and medical care for patients suffers greatly from the increase in nosocomial infections and the length of time patients stay in hospital increases by up to four days on average, which leads to major financial losses in the clinics, which have to bill according to “flat rates per case”..
In Germany, an estimated 20,000 people die every year from nosocomial infections and a further 500,000 people become infected with pathogens, most of which are already resistant to many common antibiotics. These include multi-resistant Staphylococcus aureus or E. coli and Klebsiella strains that are particularly difficult to treat.
Causes
Although the Infection Protection Act in Germany stipulates that hospitals, dialysis facilities, medical practices and day clinics have to prevent nosocomial infection according to the latest medical and scientific knowledge, this is not necessarily checked.
For this purpose, there are guidelines from the Commission for Hospital Hygiene and Infection Prevention from the Robert Koch Institute, as well as recommendations for resistance and therapies that hospitals must observe in order to prevent the spread of resistant pathogens through a nosocomial infection.
In many cases, hospital germs are spread through human contact, which is why hand disinfection is mandatory when entering and leaving the room. The qualified cleaning and disinfection of all rooms is also absolutely necessary, especially in the operating area, in order to avoid nosocomial infection.
Symptoms, Ailments & Signs
Nosocomial infections can cause different symptoms depending on the affected area of the body. The most common general symptoms include fever, cough, headache and body aches, as well as pain and pus formation in joints or surgical wounds.
Infections with multi-resistant germs (MRSA) in particular do not respond to conventional antibiotics and therefore cause fever and a general feeling of illness. In the worst case, these pathogens can get into the bloodstream and cause life-threatening sepsis (blood poisoning).
Patients treated with a urinary catheter often suffer from cystitis because infectious agents can ascend through the catheter tube into the bladder. The infection can manifest itself as fever or pain in the back. One of the most common complications during hospitalization is catheter-related infection.
Bacteria or fungi migrate from the skin along a vascular catheter into the vessel and cause inflammation there. Nosocomial infections also manifest as cough, fever, chest pain and shortness of breath. These are almost always signs of pneumonia. Pain, swelling, redness, warmth and above all pus formation indicate a wound infection after an operation.
Diagnosis & History
A nosocomial infection triggers a wide variety of clinical pictures. In intensive care units, the so-called “ventilation-associated pneumonia” is particularly noticeable, which affects 30,000 people in intensive care units in Germany every year.
Another nosocomial infection is the “catheter-associated urinary tract infection”. Statistically, this is probably the most common nosocomial infection of all. A feared complication of such urinary tract infections is a generalization of the germs from the urinary tract into the whole body, which can lead to sepsis or septic shock.
Another possibility of contracting a nosocomial infection are venous catheters, which are indispensable for many patients – whether for parenteral nutrient delivery or the administration of medication. Wound infections that occur after operations because germs penetrate the unprotected area are also very common.
Complications
The complications and the further course of this disease usually depend very much on the exact infection. For this reason, no general prediction can be made about the course. However, severe infection or blood poisoning can result in death if the infection is not treated. However, the infections can be avoided relatively well with hygiene measures, so that the patient rarely dies.
In many cases, those affected also suffer from infections of the urinary tract, resulting in burning pain when urinating. Infections and inflammation of wounds are also common and can delay wound healing. However, all of these complaints can be limited and treated well with early diagnosis and treatment, so that no further complications arise.
The life expectancy of the patient is usually not reduced with the right treatment. The treatment itself is usually carried out with the help of antibiotics and leads to success relatively quickly. However, the patient is still reported for a longer stay in the hospital.
When should you go to the doctor?
A nosocomial infection is a dangerous infection because the patient’s body is likely to be weakened by the existing condition that brought them to the hospital in the first place. Furthermore, depending on the pathogen, the immune system is on its own in the fight against it, since the pathogens can be immune to known active substances. Nevertheless, a nosocomial infection belongs in the hands of a doctor, but this is usually given by the fact that symptoms of the infection appear while the patient is still in the hospital. This is the best possible case, because the infection is recognized promptly and treatment can be initiated. In addition, the person concerned is under constant medical supervision and can therefore intervene quickly if his condition deteriorates.
On the other hand, if signs of infection appear after discharge from the hospital, the patient should contact the doctor immediately. Especially if you have symptoms immediately after an operation, there is nothing wrong with going to the emergency room. Although it can be a nosocomial infection, it can also be an infection of the surgical wounds with a pathogen that has not developed immunity to common active substances. In any case, the doctor must determine the cause and treat the infection quickly, since the patient’s body is still very weak.
Treatment & Therapy
In order to be able to treat a nosocomial infection effectively with the right antibiotics, microbiological tests are essential. For this purpose, suitable samples are taken, applied to culture media and tested for sensitivity to antibiotics.
The nosocomial infection is treated according to the so-called “antibiogram”, with antibiotic combinations being administered as a preventive measure in urgent cases. If pneumonia is suspected, the doctor rinses the lungs with saline solution and sucks out the secretion again, thus obtaining the so-called “bronchial lavage”, in which the disease-causing bacteria are found in the positive case.
In order to detect urinary tract infections, a urine sample is required, which is immediately applied to a culture medium and incubated. “Catheter-associated vein infections” can quickly lead to sepsis, which can be detected by means of a “blood culture”.
A nosocomial infection with Candida species or Staphylococcus aureus, which results in a high mortality rate, is particularly dangerous here. The typical wound infection after operations can be detected with a swab from the affected area, Staphylococcus aureus and the multi-resistant representatives of this species often settle here.
Outlook & Forecast
The prognosis of the hospital infection must be evaluated according to the individual circumstances. The cause of the infection and the pathogens must be clarified in order to be able to assess the further course. In addition, the general state of health of the person concerned must also be taken into account when making the overall prognosis.
Naturally, people are in a hospital, in nursing wards or under intensive medical care because they have already suffered from an underlying disease and have a weakened immune system. This often complicates the treatment options and worsens the further course. In risk patients, mostly harmless germs can lead to serious health consequences. It is therefore possible that a life-threatening condition develops with a nosocomial infection. The number of people who die every year from hospital infections is around 30,000 people. The organism is often so weak that it can no longer adequately defend itself against infections of all kinds.
The prognosis is significantly improved if the person affected has a generally healthy and stable immune system and his underlying disease can be classified as of little concern. With a healthy lifestyle, a balanced diet and sufficient rest, recovery can be achieved. It is also necessary to clarify the germ that has been acquired and to provide adequate drug therapy.
Prevention
Since there is not just one nosocomial infection, each clinical picture is specifically prevented. “Ventilation-associated pneumonia” requires strict hand hygiene before any work on the ventilation system and the patient must be in a semi-upright lying position at a 30° angle.
With venous catheters, colonization of the catheter tip on the outside often triggers the nosocomial infection, so there are catheters that are impregnated with antibiotics. A nosocomial infection of the urinary tract sometimes does not occur in the first place if disposable catheters are used instead of long-term urinary diversion. The aim is to push back nosocomial infections as far as possible in Germany, as in the Netherlands, and to create a better understanding of hygiene among hospital staff.
Aftercare
Nosocomial infection is an infection caused by so-called hospital germs. These pathogens are often multi-resistant to antibiotics. Acute therapy is difficult and, depending on the infection, long-term consequences for the patient cannot be ruled out. The aftercare of the nosocomial infection is therefore difficult.
On the one hand, it must be clarified whether the acute illness could be cured and whether the pathogens have permanently disappeared from the patient’s body with certain strong drugs. On the other hand, long-term effects on organs or in the metabolism must be taken into account. Long-term after-effects from the medication used must also be treated and cared for in the aftercare.
The treating specialist will check the blood parameters and vital functions as well as the organ function of the organ or organs affected by the infection at regular intervals. The nosocomial infection can have long-term consequences, for example impairment of heart or lung function. These complications must be ruled out and require strict follow-up monitoring.
A certain recovery time after the acute treatment is also essential for the patient. The specialist should advise you accordingly and take enough time for the patient and his questions.
You can do that yourself
Depending on the type and severity of the nosocomial infection, patients can do a number of things themselves to alleviate the symptoms and symptoms. First of all, the body needs a lot of rest. Those affected should take a few days off and mainly eat bland food during the illness.
General measures such as drinking plenty and avoiding alcohol and cigarettes will help with recovery. In addition, other people should be avoided for a certain period of time to avoid contagion. If you have a sore throat, lozenges or salt water solutions for inhalation help. The natural remedy Echinacea strengthens the immune system and can be taken either as a tea or as a plant juice. Strict personal hygiene also helps with a bacterial infection.
If the symptoms do not subside despite everything, the family doctor must be consulted. It is important to determine the triggering pathogen, for example by investigating in the hospital where the pathogens for the nosocomial infection were admitted. There may be a serious infection that needs to be treated with medication in addition to self-treatment. Patients should discuss with their family doctor which measures will best help against their individual symptoms.
