HIC 3 Hospital Associated Infection (HAI)

posted Jan 20, 2011, 4:16 AM by Dr.Murali BK   [ updated Feb 1, 2011, 3:48 AM by monica d ]

General guide - Hospital Acquired infection

Hospital-acquired infection is usually one that first appears three days after a patient is admitted to a hospital or other health-care facility. Infections acquired in a hospital are also called Nosocomial infections.


Hospital-acquired infections can be caused bacteria, viruses’ fungi, or parasites.
These microorganisms may already be present in the patient's body or may come from the environment, contaminated hospital equipment, health-care workers, or other patients.
An infection may start in any part of the body. If a surgical wound in the abdomen becomes infected, the area of the wound gets infected
A generalized infection is one that enters the blood stream and causes general systemic symptoms such as fever, chills, low blood pressure.
Hospital-acquired infections may develop from surgical procedures, catheters placed in the urinary tract or blood vessels, or from material from the nose or mouth that is inhaled into the lungs.

The most common types of hospital-acquired infections are Urinary tract infections, pnemonea and surgical wound infections.

·         Persons with compromised immune systems  are more likely to get an infection.
·         Prolonged hospital stay
·         Use of indwelling catheters
·         Failure of hospital staff to wash their hands
·         Overuse of antibiotics

·         Fever is often the first sign of infection.
·         Other symptoms and signs of infection are rapid breathing, mental confusion, low blood pressure, reduced urine output, and a high white blood cell count.

Patients with a UTI may have pain when urinating and blood in the urine.
·         Symptoms of pneumonia may include difficulty breathing and coughing.
·         A localized infection causes swelling, redness, and tenderness at the site of infection.

Diagnosis of a hospital-acquired infection is based on:
·         symptoms and signs of infection
·         examination of wounds and catheter entry sites-
·         Wounds and the skin where catheters have been placed are examined for redness, swelling, or the presence of pus or abscess
·         The physician reviews the patient's record of procedures performed in the hospital to determine if any posed a risk for infection and review of procedures that might have led to infection.
·         laboratory test results-
1.  CBC can reveal if the WBC is high.
2.  White blood cells or blood may be present in the urine when there is a UTI.
3.  Cultures of blood, urine, sputum, other body fluids, Catheter tip, or tissue are done to look for infectious microorganisms.
·         X Ray chest is done to look for infiltrates of white blood cells and other inflammatory substances in the lung tissue.
·         Samples of sputum can be studied with a microscope or cultured to look for bacteria or fungi.


Once the source of the infection is identified, the patient is treated with antibiotics or other medication that kills the responsible microorganism.

Hospital-acquired infections are serious illnesses that cause death in about 1% of cases. Rapid diagnosis and identification of the responsible microorganism is necessary, so treatment can be started as soon as possible.

·         All the staff should adhere the infection control policies developed by the infection control team in the hospital to prevent nosocomial infections
·         High risk procedures such as urinary catheterizing should be performed only when necessary and catheters should be left in for as little time as possible.
·         Medical instruments and equipment must be properly sterilized to ensure they are not contaminated.
       The nurses should follow the Policy nursing barrier/Isolation
·         Frequent hand washing by staff and visitors is necessary to avoid passing infectious microorganisms to hospitalized patients.
·         Antibiotics should be used according to the antibiotic policy. Overuse of antibiotics is also responsible for the development of bacteria that are resistant to antibiotics.