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Nosocomial infections
ℹ️ About
- 🏥 Infections acquired during a hospital stay are called nosocomial infections.
- 🕒 Defined as infections arising >72 hours after admission.
- Earlier infections are usually community-acquired.
- ⚠️ Short-stay patients may only develop symptoms after discharge.
- 📊 Affect ~10% of admitted patients in the UK.
- Spread by 👋 direct hand contact and 💨 droplet transmission.
👥 Most Vulnerable
- Extremes of age ➝ 👶 neonates, 👵 elderly.
- Immunosuppressed: 💉 chemotherapy, diabetes, long-term steroids.
- Recent surgery 🩺.
- Ventilated patients 🫁.
- Indwelling devices: catheters, drains, central lines, prosthetics.
📍 Commonest Sites
- 💧 Urinary tract infections (catheter-associated).
- 🫁 Respiratory tract infections ➝ hospital-acquired pneumonia.
- 🩹 Surgical site infections.
- 🧬 Bacteraemia.
- 🔥 Skin infections (burns, IV sites).
- ❤️ Endocarditis.
🦠 Microbiology
- Staphylococcus aureus (including MRSA), Pseudomonas, E. coli.
- Clostridioides difficile ➝ after broad-spectrum antibiotics.
- Viruses ➝ e.g. small round structured viruses (SRSV) causing institutional diarrhoea.
- Fungi ➝ Candida, Aspergillus (especially in immunosuppressed).
🧬 Resistance
- MRSA: resistant to flucloxacillin and most anti-staphylococcal antibiotics. Treated with Vancomycin or Teicoplanin. Nasal/skin carriage managed with topical creams + antiseptic washes.
- VRE (Vancomycin-resistant Enterococcus): increasingly common and difficult to treat.
🛡️ Prevention
- ✋ Strict hand hygiene after every patient contact.
- 💉 Strict aseptic care of central lines and invasive devices.
- 🚪 Immediate isolation of infected cases (side-room, ward-level, or cohorting).
- 💊 Judicious use of prophylactic antibiotics only when indicated.
- 🏃 Early mobilisation and discharge to shorten exposure risk.
- 🧤 Staff/visitors: gloves, aprons, masks as appropriate.
- 🧴 Alcohol gel for routine hand disinfection.
- 🧼 Soap + water for hand washing when C. difficile suspected (alcohol does not kill spores).
- 🛡️ High-risk neutropenic patients: reverse barrier nursing (protective isolation).
- 🚫 Avoid overuse of antibiotics, especially broad spectrum. Use combination therapy where resistance risk is high.
| The content on this website is provided for educational and informational purposes only to support exam preparation (e.g., MLA, MRCP, USMLE) and learning. This is NOT medical advice, diagnosis, treatment, or professional guidance. It does not replace consultation with a qualified healthcare professional, official guidelines (e.g., NICE, GMC, BNF), or supervised clinical practice. Always verify information with current, authoritative sources. Makindo and its contributors accept no liability for any reliance on this content, including errors, omissions, or any resulting harm, loss, or consequences. By using this site, you agree to these terms. |
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