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Nosocomial Infections
By virtue of definition Nosocomial infections are the infections which develop during hospitalization and
were not incubating or present at the time of admission to the hospital. The source of causative infecting
organism may be exogenous-from another patient or a member of hospital staff or from the inanimate
environment in the hospital. It may be endogenous from the patient's own flora which at the time of
infection may invade the patient's tissues spontaneously or be introduced into them by surgical
operation, instrumental manipulations and nursing procedures
The source of causative infecting organism may be exogenous-from another patient or a member of
hospital staff or from the inanimate environment in the hospital. It may be endogenous- from the
patient's own flora which at the time of infection may invade the patient's tissues spontaneously or be
introduced into them by surgical operation, instrumental manipulations and nursing procedures.
• Hospital environment is heavily laden with a variety of pathogens. Organisms present in air, dust,
antiseptic lotion, water and food or may spread from shedding from the patients.
• Hospital microbial flora is usually multi-drug resistant. Patients have impaired defence mechanism
due to: Disease therapy and investigations in the hospital.
• Instrumentation in hospitals may introduce infection.
• Blood, blood products and intravenous fluids may transmit many infections.
• Accidental inoculation of infectious material
Modes of Spread:
Various modes of spread of Nosocomial infections are:
a. Airborne
b. Infection by contact
c. Infections acquired from food.
d. Infections associated with water.
e. From hospital equipment
f. Infections by inoculation.
Common Types of Hospital Infections Include:
a. Wound infections
b. Urinary tract infections
c. Respiratory infections
d. Skin infections
e. Bacteraemia and septicaemia
f. Gastrointestinal infections.
Gram-positive: Gram-negative:
Viruses: Fungi:
Hepatitis B Aspergillus
Hepatitis C Candida albicans
Hepatitis D
HIV
Herpes viruses Parasites:
Cytomegalovirus Toxoplasma gondii
Influenza virus Entamoeba
Enteroviruses histolytica
SARS Co V Pneumocystis jiroveci
(earlier known as P.
carinii)
• Hand washing
• Intelligent use of instrumentation
• Limitation of use of antibiotics
• Prophylactic antibiotics in specific situations for short periods Limitations of transfusions
• Barrier precautions
• Surveillance
• Frequent change of intravenous lines
Parasites: Bacteria:
Plasmodium vivax, P. falciparum Treponema pallidum, Brucella
P. malariae, P. ovale abortus, Proteus species
Toxoplasma gondii Esch. Coli, Klebsiella species
Trypanosoma cruzi Micrococcus, Enterobacter
Wuchereria bancrofti Salmonella cholerasuis,
Brugia malayi, Loa loa Pseudomonas species, Staph.
Leishmania donovani, B. microti Epidermidis, R. rickettsii
Viruses: Fungi:
Hepatitis B virus, Hepatitis C virus Aspergillus
Hepatitis D virus, HIV 1 and 2
HTLV I & II, Hepatitis A virus Penicillium
Cytomegalovirus, Epstein-Barr virus
Parvovirus, Ebola virus, Hormodendrum
Lassa virus,Yellow fever virus
Dengue virus