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Straight, No Chaser: Hospital-Acquired Infections

By Jeffrey Sterling, MD November 15, 2018

NOSOCOMIAL INFECTIONS

“I don’t go to hospitals because that’s where the diseases are.” I used to hear that refrain early in my career, often from elderly patients. I would routinely shake my head at the lack of risk/benefit ratio analysis inherent in that statement, but as they say, with age comes wisdom. Now I find myself cautioning patients and parents of the dangers of unnecessarily coming to the emergency room for minor problems or even visiting the medical wards. This consideration is especially true for patients with reduced immune systems (e.g. HIV, diabetes, those on steroids) and newborns during the first month of their lives (before they’ve developed their own immune systems and before they’ve started receiving vaccines). Today’s goal is to empower you so you can ask your hospital team the correct questions to reduce your risks when you need to be at or in the hospital.

Healthcare (aka hospital aka nosocomial) acquired infections (HAI) is a real thing. According to the World Health Organization, it is the most common adverse occurrence in all of healthcare. Of every 100 hospitalized patients in developed countries, 7 will acquire a HAI; that number rises to 10 in developing countries. Even in high-income countries like the U.S., 30% of patients admitted to the intensive care unit (ICU) develop at least one infection. All of this results in hundreds of millions of infections across the world each year and 1.7 million affected patients in the U.S.

HAI piechart

The most common types of infection are well-known.

  • Urinary tract infections are the most common HAI, followed by pneumonias.
  • Surgical site infections are also common, affected approximately 30% of patients receiving operations. These are nine times more likely in facilities in developing countries than in developed countries.
  • Patients placed on a ventilator (the machine used to breathe for you during critical illnesses) and receiving central lines (special intravenous lines to develop fluid and medicine more directly to the heart) are also at very high risk for developing infections.

HAI prevention

Regardless of the hospital, there are circumstances more likely to promote the development of a HAI. Consider the following and assertively ask your hospital team about infection control procedures and your concerns.

  • Inadequate environment hygienic conditions and waste disposal protocols (Does your hospital just look dirty? Do you see mosquitoes, flies and/or roaches?)
  • Administration of prolonged (and/or inappropriate) doses of antibiotics (Anything that prolongs your hospital stay increases your infection risk.)
  • Prolonged (and/or inappropriate) use of invasive devises (e.g. various tubes)
  • Overcrowded facilities
  • Understaffed facilities
  • Lack of application of basic infection control measures (Does your hospital staff wear gloves, masks and gowns often?)
  • Use of high-risk and sophisticated medical and/or surgical procedures

Hospital Acquired Infections Infographic

Review this info graphic, which says it all. You should feel comfortable approaching the hospital staff and asking about hygiene. At least observe them wash their hands or use antiseptic as they enter and leave your hospital room. After all, that’s where the diseases are.

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