Hospital acquired infection.

1. Bsc Nursing
Microbiology
Unit – 3 (nosocomial
infection )
BY :- PRAGYA TIWARI

2. Nosocomial Infection
 Hospital acquired infection Are those which are developed in a patient after
admission to the hospital due to some other illness.
 Hospital have generally served as a source of infection to patient after intering
into hospital specially after admission. This is known as nosocomial infection
(nosocomion mean “Hospital”).
 These are defined as infection developing patient after admission to the hospital,
which were neither present, nor in incubation at the time of hospitalisation.
 These infection may manifest during their stay in hospital or sometimes after the
patient discharge.

3. Source
 EXAGENOUS: It source may be another person in the hospital (cross
infection) or a contaminated item or equipment of building service
(inuironment infection)
Eg : Contact with Other patients & stuff
Environmental source
Inanimate objects
 ENDOGENOUS: The infecting organisms are drived from the patient own
skin, GI or upper respiratory system.

4. Factors inducing hospital infections are
1. AGE: Neonate and elderly age people are more susceptible for hospital acquired infection
becouse of there longer stay &with inefficient immunity.
2. SUSCEPTIBILITY: Hospitalised patient with pre-existing disease. Like – diabetes etc are high risk
group & more susceptible to infection.
3. INFECTED PATIENT: Community acquired or non – hospital infection. The patient inters the
hospital due to pathogenic micro-organism.
4. HOSPITAL ENVIRONMENT: Where if not clean transmit disease easily.
5. SURGICAL & DIAGNOSTIC PROCESS: The natural difence mechanism of body surface may be
by pass by the injury or by a diagnostic or therapeutic interventions like : catheter.
6. BLOOD TRANSFUSION:-
MODE OF TRANSMISSION
 CONTACT: Most common route of transmission for hospital infection are:-
• Direct contact: spread from person to person.

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•Indirect contact: Spread via contaminated hands & equipment.
 AIR BORN SPREAD: Infections may be spread by air
•Dropletes: Respiratory disease transmitted by inhalation
•Dust: From beding, floor, a wound during dressing & from the skin etc.
 ORAL ROUTE: Hospital food cantain gram –ve bacilli which are most aften antibiotics resistance,
which may calanies the gut and later cause infection in susptible host.
 PARENTERAL ROUTE : (Insulation) with the use of disposable, needles, syrings & other device
& transmission of infection by parentral route in frequent. However certain infection may be
transmitted by blood transfusion & tissue donation & contaminated infusion fluid & from
accidental injury with contaminated sharp with HIV.
 CROSS INFECTION & SELF INFECTION: Self infection may cause due to transfer into the
wound of the staphalocucci.
Cross infection may result from staphalocucci derived from other patient or healthy stuff.
 ANIMAL : Zoonatic infection are transmitted through animal.
 INSECTS: Acts as actors in transmission on of several disease.

6. Common hospital acquired infection
 Urinary tract infection: Most hospital acquired infection urinary tract are
associated with. Urethral catheterization.infection can be prevented by strict
asepsis during catheterization.
 Respiratary infection: Aspirations in uncanrious patient and pulmonary
ventilation or instrumentation to deal to nosocomial pneumonia.
 Wound & skin sepsis :The encidence of post operatic infection is higher in
elderly patients most wauna infection manifest with in a weeK of surgery.
 Septesemia and bacterimia: These may be consequences of infection at any site
but are commonly caused by infected intervenus cannula intravenus be
rehydration in diarrhoea should be restricted to emergencies & should be
replaced by oral fluids as earliest possible.

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 GI tract infection: Food paisoning & neanatal septicemia in hospital have been
reported.
 Burn: It is a primary suspect ( pseudo manas) in burn infection.

8. Prevention and Control
The hospital acquired infection can be prevented by following means.
 Sterilization: The pravision of sterile instruments dressing, surgical gloves, face
mask, clothing is very important in hospital practise.
 Cleaning & Disinfection: The general hospital inuironment can be kept in good
order by altention of basic cleaning ,waste disposal and laundry.
 Skin disinfection and antiseptic:-
•Hand washing :Through hand washing after any procedure, involving
nursing care or close cantact with the patient is essential.
•Asepsis: The asepsis is divided into 2 categories
1. Medical 2. Surgical

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 Protective clothing: Defferent activities within the hospital require defferent Dgree of
protection to staff and patients.
 Equipment: It should be assist to determine the appropriate method frequency &site of
diontamination
 Haspital building & design: The rautun maintance of the hospital building to insure that
surface whenever possible are smooth and easy to clean.
1. Monitoring : Monitoring of the physical performance of air canditaninh plants and
machanry used disinfection and sterilization is essential.
2. Surveillance and ales laboratories: Detection and cathetirization of hospital infection
incident of etc