Nosocomial Infections - Symptoms, causes and treatment

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Nosocomial Infections - Symptoms, causes and treatment
Nosocomial Infections - Symptoms, causes and treatment

Nosocomial infections are infections that occur in a hospital environment. A person is said to have a nosocomial infection if the infection is acquired while in or undergoing treatment in a hospital

Nosocomial infections can occur in patients, nurses, doctors, and hospital workers or visitors. Some examples of diseases that can occur due to nosocomial infections are bloodstream infections, pneumonia, urinary tract infections (UTI), and surgical site infections (ILO).

Nosocomial Infection - Alodokter

Causes of Nosocomial Infection

Nosocomial infections are most often caused by bacteria. This bacterial infection is more dangerous because it is generally caused by bacteria that are resistant to antibiotics, such as MRSA or ESBL-producing bacteria. Nosocomial infections due to these bacteria can occur in patients who are receiving treatment in a hospital or patients with a weak immune system or immune system.

In addition to bacteria, nosocomial infections can also be caused by viruses, fungi, and parasites. Transmission of nosocomial infections can occur through air, water, or direct contact with patients in the hospital.

Risk factors for nosocomial infection

There are a number of factors that can increase the risk of a person in a hospital setting getting nosocomial infections, including:

  • Has a weak immune system, for example due to HIV/AIDS or taking immunosuppressant drugs
  • Suffer from coma, serious injury, burns, or shock
  • Has access or frequent contact with patients who are suffering from infectious diseases, without using personal protective equipment according to operational standards (SOP)
  • Receiving more than 3 days or long-term care in the ICU
  • Over 70 years old or still a baby
  • Has a history of taking antibiotics in the long term
  • Using a breathing apparatus, such as a ventilator
  • Using infusions, urinary catheters, and endotracheal tubes (ETT)
  • Undergoing surgery, such as heart surgery, bone surgery, surgery to implant medical equipment (such as a pacemaker or implant), or organ transplant surgery

In addition to the above factors, the crowded hospital environment, the activity of transferring patients from one unit to another, and the placement of patients with weak immune systems with patients suffering from infectious diseases in the same room, can also increase the risk of infection. risk of nosocomial infection.

Symptoms of Nosocomial Infection

Symptoms suffered by patients with nosocomial infections can vary, depending on the infectious disease that occurs. Symptoms that can appear include:

  • Fever
  • Rash on skin
  • Shortness of breath
  • Fast pulse
  • Body feels weak
  • Headache
  • Nausea or vomiting

In addition to the general symptoms mentioned above, symptoms can also arise according to the type of nosocomial infection that occurs, such as:

  • Blood flow infection, with symptoms in the form of fever, chills, decreased blood pressure, or redness and pain at the infusion site if infection occurs through infusion
  • Pneumonia, with symptoms of fever, shortness of breath, and coughing up phlegm
  • Surgery wound infection, with symptoms in the form of fever, redness, pain, and discharge of pus in the wound
  • Urinary tract infection, with symptoms such as fever, pain when urinating, difficulty urinating, lower abdominal or back pain, and blood in the urine

When to see a doctor

You need to check yourself or consult a doctor if you feel any symptoms of nosocomial infection as mentioned above, especially if these symptoms appear after you receive treatment at the hospital.

Symptoms of nosocomial infection can appear in the following timeframes:

  • From the time he was admitted to the hospital until 48 hours later
  • Since leaving the hospital until 3 days after
  • From the end of the operation until 90 days after

Diagnosing Nosocomial Infections

The doctor will ask the patient's complaints and symptoms, then perform a physical examination to determine the patient's condition and whether there are signs of local infection on the skin.

To confirm the diagnosis, the doctor will perform the following investigations:

  • Blood test, to detect signs of infection from blood cell levels
  • Urine test, to determine whether there is an infection in the urinary tract, including to see the type of bacteria that infects
  • Sputum test, to find out the type of bacteria that infects the respiratory tract
  • Culture of blood, sputum, or surgical wound fluid, to determine the presence and type of bacteria, fungi, or parasites causing the infection
  • Scan CT scan, MRI, ultrasound, or X-ray, to detect damage and signs of infection in certain organs

Treatment of Nosocomial Infections

If it is suspected that the cause of the infection is bacteria, the doctor will give antibiotics empirically. Empirical antibiotic therapy is the initial administration of antibiotics, before the type of bacteria causing the infection is known with certainty.

Hopefully, these antibiotics can control or kill the bacteria that cause infection while waiting for the culture results to come out. After the culture results come out, the administration of antibiotics and other drugs will be adjusted according to the type of bacteria or germs that cause nosocomial infections.

If the nosocomial infection is caused by a surgical wound infection or pressure ulcer, a debridement operation will be performed. This procedure is useful for removing infected and damaged tissue so that the infection does not spread.

Supportive therapy, such as giving fluids, oxygen, or medication to treat symptoms, will be given according to the patient's condition and needs. Supportive therapy is carried out to ensure that the patient's condition remains stable.

When possible, all devices that increase the risk of infection will be removed or replaced.

Nosocomial Infection Complications

Nosocomial infections that are not treated immediately can cause various complications such as:

  • Endocarditis
  • Osteomyelitis
  • Peritonitis
  • Meningitis
  • Sepsis
  • Lung abscess
  • Organ failure
  • Gangrene
  • Permanent damage to the kidneys

Nosocomial Infection Prevention

Steps to prevent nosocomial infections are the responsibility of all people in the hospital, including he alth workers, such as doctors and nurses, patients, and visiting people. Some steps that can be taken to prevent the spread of this infection are:

1. Wash hands

It is important for everyone in the hospital to wash their hands properly according to WHO recommendations. There are 5 mandatory times to wash your hands while in the hospital, namely:

  • Before holding the patient
  • Before performing procedures and actions on patients
  • After exposure to body fluids (eg blood, urine, or feces)
  • After touching the patient
  • After touching objects around the patient

2. Keep the hospital environment clean

The hospital environment needs to be cleaned with a cleaning fluid or disinfectant. Hospital floors need to be cleaned 2-3 times per day, while the walls need to be cleaned every 2 weeks.

3. Use the tool according to the procedure

Medical procedures and the use of devices or tubes attached to the body, such as infusions, breathing apparatus, or urinary catheters, must be used and installed according to standard operating procedures (SOPs) that apply in each hospital and he alth facility.

4. Place patients at risk in isolation rooms

The placement of the patient must be in accordance with the condition and illness suffered. For example, patients with low immune systems or patients who have the potential to transmit the disease to other patients will be placed in isolation rooms.

5. Use PPE (personal protective equipment) according to SOP

Staff and everyone involved in hospital services need to use personal protective equipment according to SOPs, such as gloves and masks, when serving patients.

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