What are hospital-acquired infections?
As the name implies, acquired infections are transmitted in hospitals or other healthcare facilities such as rehabilitation centres or nursing homes, where the patient’s immune system is weak and more sensitive to infections. HAI often occur in intensive care units. Therefore, they are also referred to as health care-associated infections (HCAI), because they do not only present themselves in hospitals.
One in 10 patients is infected with HAI. It is more common in developing countries, and more than 40% of hospital stays in Latin America and Asia lead to HAI. This is associated with costs and increased mortality.
How are H(C)AI transmitted?
Infections can be acquired outside the healthcare facility, caused by other patients, nurses or even the patient’s own skin, if the microorganism breaks through the skin barrier. There are several ways to transmit HAI. For example, via laundry, air, contaminated equipment, personnel or – as mentioned above – the patient’s own skin.
The most common transmission is direct contact or droplets that change the host by talking or sneezing and coughing. Microorganisms transmitted by air are Legionella, Mycobacterium tuberculosis, Rubella and Varicella. They can travel long distances because they are carried by the air stream and then accidentally inhaled by another person. But there are also contact infections caused by equipment, apparatus or other people and by infectious food via the gastrointestinal tract. Insects can carry microorganisms, too.
How can H(C)AI be detected?
Symptoms vary from type to type, but usually a patient develops SSI, meningitis, pneumonia or urinary tract infections. HAI can also cause fever, shortness of breath, headaches, diarrhoea, nausea and leakage of wound secretion.
How are H(C)AI treated?
There are two infections that patients usually suffer from: Gram-positive strains of MRSA (methicillin-resistant Staphylococcus aureus) and gram-negative Acinetobacter baumannii. While MRSA is quite easy to treat, only a handful of effective antibiotics are available to treat Acinetobacter baumannii. In the worst case, infected persons have to be isolated in order to prevent further infection.
How can H(C)AI be prevented?
Irrespective of the type of infection, it is recommended to take QA/QC measures, continuously monitor air quality in the premises, hygiene protocols and guidelines for sterilization of instruments, hand hygiene, surface cleaning and the use of antibiotics, alcoholic rub-in preparations and hot water treatment. These steps can reduce the risk of HAI by 70%.
To cut a long story short: the answer is hospital hygiene.
Patients should be encouraged to inform staff of any complaints and symptoms. Staff and, in certain cases, visitors should also be encouraged to disinfect their hands properly.