a study about the infections that are cought in the hospital. usually they are antibiotic resistant infections. they include urinary tract infections (UTIs) surgical site infections gastroenteritis meningitis pneumonia they are also called HAIs Hospital Acquired Infections.

1. NOSOCOMIAL INFECTIONS
ASNAD KHAN
ROLL NO 19TH
SUBMITTED TO ; SIR DR. MUHAMMAD JAVED
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2. OUTLINE
1. DEFINITION
2. EPIDIMOLOGY
3. MAJOR SITES OF Nis
4. PATHOGENESIS
5. SOURCES
6. TRANSMISSION
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3. DEFINITION
The Term “Nosocomial” Comes From Two
Greek Words
“ Nosus” Means “Disease”
“Komeion” Means “To Take Care Of”
Hence,
The Term Nosocomial Is Now Used For The
Infections That Have Been Caught In Hospital
OR Infections Caused By Organisms That Are
Resistant To Antibiotics.
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4. EPIDEMIOLOGY OF NOSOCOMIAL
INFECTIONS
Nosocomial infections (also known as hospital-acquired
infections, hospital-associated infections and hospital infections).
They are not present in the patient at the time of admission to a
health-care facility but develop during the patient’s stay.
Nosocomial infections occur as a result of medical procedures
performed on patients that lead to infections from a patient’s own
(endogenous) flora or as a result of exposure to items
contaminated with infectious agents.
Human beings are reservoirs of numerous types of
microorganisms. Faeces contain approximately 1013 bacteria per
gram, and the number of microorganisms on skin varies between
102 and 104 per cm2.
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5. NOSOCOMIAL INFECTIONS
5-10% of patients admitted to acute care
hospitals acquire infections
2 million patients/year
¼ of nosocomial infections occur in ICUs
90,000 deaths/year
Attributable annual cost: $4.5 – $5.7 billion
Cost is largely borne by the healthcare facility not
3rd party payors
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6. •Infections acquired in the hospital
– infection was neither present nor incubating
when admitted
– 2 million infections in 1995 in USA
– 90,000 deaths
–may range from mild to serious (including death)
• Although acquired in the hospital-may appear
after discharge from hospital
• Some infections occur in outbreaks or clusters
(10%)
– but majority are endemic
• Can result from diagnostic or therapeutic
procedures
– catheters in bladder or blood vessel, surgery
–correlate with length of stay
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7. MAJOR SITES OF INFECTION IN
MEDICAL ICU
30%
30%
16%
5%
5% 6%
3%
1%
4%
PNE
UTI
BSI
OTHR
SST
EENT
CVS
GI
LRI
Nosocomial infections occur predominantly in
Intensive Care Units
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8. PATHOGENESIS OF NOSOCOMIAL
INFECTIONS
3 ingredients
Susceptible host
Virulent organism
Portal (mode) of entry
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9. PATHOGENESIS OF NOSOCOMIAL
INFECTIONS
 Host defenses depressed by underlying
disease or treatment, malnutrition, age
 Anatomic barriers breached (IV’s, foleys,
vents etc.)
 Exposure to virulent pathogens
many resistant to multiple antibiotics
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10. WHERE DO THE MICROBES COME FROM?
• patient's own flora
• cross infection from medical personnel
• cross infection from patient to patient
• hospital environment- inanimate objects
- air
- dust
- IV fluids & catheters
- washbowls
- bedpans
- endoscopes
- ventilators & respiratory equipment
- water, disinfectants etc
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11. The Inanimate Environment
Can Facilitate Transmission
.
X represents VRE culture positive sites11

12. SOURCES OF PATHOGENS
 Reactivation of latent infection: TB, herpes viruses
 Less common
 Endogenous: normal commensals of the skin, respiratory, GI,
GU tract
 common
 Exogenous
 Inanimate environment: Aspergillus from hospital
construction, Legionella from contaminated water
 Animate environment: hospital staff, visitors, other
patients
Cross transmission- common
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13. MECHANISMS OF TRANSMISSION
 Contact: direct (person-person), indirect
(transmission through an intermediate object--
contaminated instruments
 Cross transmission
 Airborne: organisms that have a true airborne
phase as pattern of dissemination (TB, Varicella)
 Common-vehicle: common animate vehicle as
agent of transmission (ingested food or water,
blood products, IV fluids)
 Droplet: brief passage through the air when the
source and patient are in close proximity
 Arthropod: not reported in US
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14. SITES OF NOSOCOMIAL
INFECTIONS
 Urinary tract 40%
 Pneumonia 20%
 Surgical site 17%
 Bloodstream (IV) 8%
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15. THE END
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