Hailey Tran
Bacterial infections are diseases caused by harmful bacteria that can affect many parts of the body, including the skin, lungs, brain, and blood. They can be minor or serious and are often treated with antibiotics. Hospital-acquired infections (HAIs) are a major challenge to patient safety and can increase the length of hospital stay, healthcare costs, and mortality. About 1 in 10 hospitalized patients will contract an HAI, and the risk factors include immunosuppression, older age, length of hospital stay, and frequent visits to healthcare facilities. While hospitals implement infection control practices, bacterial infections remain a significant concern, especially with the emergence of antimicrobial resistance. The decision to extend a hospital stay due to a bacterial infection depends on various factors, including the type and severity of the infection, the patient's overall health, and the effectiveness of treatment.
| Characteristics | Values |
|---|---|
| Risk factors for hospital-acquired bacterial infections | Immunosuppression, older age, length of stay in the hospital, multiple underlying comorbidities, frequent visits to healthcare facilities, mechanical ventilatory support, recent invasive procedures, indwelling devices, and stay in an intensive care unit (ICU) |
| Bacterial infections that are hospital-acquired | Clostridioides difficile (C. diff), Staphylococcus aureus (staph), MRSA, Acinetobacter, Klebsiella |
| Common symptoms of bacterial infections | Fatigue, redness, blisters, ulcers, swollen or painful skin, diarrhea, stomach pain, nausea, vomiting, cough, shortness of breath, chest pain, phlegm, neck stiffness, sensitivity to light, confusion, high fever, weakness, sweating, low blood pressure, muscle and joint pain, burning or pain during urination, discharge, increased need to urinate, painful intercourse |
| Treatment for bacterial infections | Antibiotics, bed rest, removal of foreign devices such as catheters, healthy diet, fluid intake, and rest |
| Prevention of hospital-acquired bacterial infections | Handwashing, established rules for infection prevention, educating healthcare workers about infection control procedures, use of aseptic techniques for invasive procedures, securing catheters, disinfecting hospital rooms, reducing environmental contamination, establishing a hospital committee to oversee the use of antibiotics |
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What You'll Learn
Hospital-acquired bacterial infections
Anyone admitted to a healthcare facility is at risk of contracting a hospital-acquired infection (HAI). HAIs are nosocomial infections that are typically absent or incubating at the time of admission and usually acquired after hospitalization. They are monitored by agencies such as the National Healthcare Safety Network (NHSN) of the Center for Disease Control and Prevention (CDC). The risk of contracting an HAI depends on the facility's infection control practices, the patient's immune status, and the prevalence of pathogens within the community. Risk factors include immunosuppression, older age, length of hospital stay, multiple underlying comorbidities, frequent visits to healthcare facilities, mechanical ventilatory support, recent invasive procedures, indwelling devices, and ICU stays.
HAIs are associated with morbidity, mortality, and increased healthcare costs. They can be caused by bacteria, fungi, or viruses, with bacteria accounting for about 90% of cases. Common types of HAIs include central line-associated bloodstream infections (CLABSI), catheter-associated urinary tract infections (CAUTI), surgical site infections (SSI), hospital-acquired pneumonia (HAP), ventilator-associated pneumonia (VAP), and Clostridium difficile infections. Symptoms that may indicate an HAI include a productive cough, shortness of breath, abdominal pain, rebound tenderness, altered mental status, palpitations, suprapubic pain, polyuria, dysuria, and costovertebral angle tenderness.
HAI prevention strategies include educating healthcare workers about infection control procedures, handwashing, using aseptic techniques for invasive procedures, securing catheters, disinfecting hospital rooms, and reducing environmental contamination. Early detection and treatment of HAIs are crucial, and patients should report any new symptoms during their hospital stay. Treatment options include antibiotics, bed rest, removal of foreign devices, a healthy diet, fluid intake, and rest.
HAIs are more prevalent in developing countries, with rates exceeding 40% in Latin America, Sub-Saharan Africa, and Asia. In the US, the estimated number of HAIs in hospitals in 2015 was 687,200, affecting 633,300 patients. Clostridioides difficile infection, or C. diff, is the most common HAI in the United States, causing approximately 500,000 infections annually. Other common HAIs include Staphylococcus aureus ("staph") and MRSA, which is a type of staph resistant to certain antibiotics.
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Risk factors for hospital-acquired infections
Anyone admitted to a healthcare facility is at risk of contracting a healthcare-associated infection (HAI). However, some people are at a higher risk of contracting an HAI than others.
- Age: Older people are at a higher risk of contracting an HAI. A study found that patients with hospital-acquired infections were older than those who did not acquire the infections (median age of 79 compared to 72).
- Immune status: People with weakened immune systems are more susceptible to HAIs. This includes people with diseases that compromise their immune system and those undergoing treatments such as chemotherapy, radiation, or steroids.
- Length of stay: A long hospital stay increases the risk of acquiring an infection.
- Intensive care unit (ICU) admission: The ICU is one of the most common wards where HAIs occur, as doctors treat serious diseases. About 1 in 10 people admitted to a hospital will contract an HAI.
- Invasive procedures: Some procedures that bypass the body's natural protective layer, such as the insertion of urinary catheters, IV cannulas, respiratory equipment, and drain tubes, can introduce infections.
- Indwelling devices: The use of indwelling devices such as urinary catheters and breathing tubes has been associated with an increased risk of HAIs, including severe sepsis.
- Non-intact skin: Wounds, incisions, burns, and ulcers are more prone to infection than intact skin.
- Hand hygiene: Inadequate hand hygiene practices by hospital staff, visitors, and patients can increase the risk of infection.
- Antibiotic use: The overuse of antibiotics can lead to resistant bacteria, making infections more challenging to treat. Additionally, receipt of intravenous antibiotics within the last 90 days is a major risk factor for developing antimicrobial resistance.
- Previous colonisation: Previous colonisation with certain bacteria may increase the risk of contracting an HAI.
- Multiple underlying comorbidities: Patients with multiple underlying health conditions are at a higher risk of HAIs.
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Preventing hospital-acquired infections
Anyone admitted to a healthcare facility is at risk of contracting a hospital-acquired infection (HAI). HAIs are associated with morbidity, mortality, and healthcare costs. The risk factors for HAI include immunosuppression, older age, length of hospital stay, multiple underlying comorbidities, frequent visits to healthcare facilities, mechanical ventilatory support, recent invasive procedures, indwelling devices, and stay in an intensive care unit (ICU).
Hand Hygiene
Hand hygiene is a simple yet effective way to prevent the spread of HAIs. Healthcare workers should practice proper handwashing techniques, such as washing their hands before and after interacting with patients, to reduce the transmission of pathogenic microorganisms. Alcohol-based hand sanitizers can be used when soap and water are not accessible.
Infection Control Procedures
All healthcare facilities should have established infection control procedures and policies, and staff should be educated about them. Nurses play a vital role in prevention as they are often the first to encounter infected patients. They should ensure that everyone follows the established rules for infection prevention, including handwashing, using aseptic techniques for invasive procedures, and securing catheters.
Environmental Hygiene
Maintaining a clean and safe hospital environment is crucial. Hospital rooms, surfaces, and equipment should be regularly disinfected to reduce microbial contamination. Particular attention should be paid to high-touch surfaces such as bed rails, door handles, call bells, and light switches.
Antibiotic Stewardship
The emergence of antimicrobial resistance is a significant concern. Hospitals should employ programs to improve antibiotic prescribing practices and reduce unnecessary antibiotic use. A hospital committee, including a pharmacist, should oversee the use of antibiotics to ensure they are not overprescribed and to manage antimicrobial resistance.
Early Detection and Treatment
Early detection and treatment of HAIs are vital. Patients should report any new symptoms during their hospital stay, and healthcare providers should be vigilant in identifying potential HAIs. Treatment should be initiated promptly, and foreign devices, such as catheters, should be removed as soon as medically appropriate to encourage natural healing.
By implementing these strategies and maintaining a culture of safety, teamwork, and communication, healthcare facilities can effectively reduce the risk of HAIs and improve patient outcomes.
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Treating bacterial infections
Bacterial infections are diseases caused by single-celled organisms that multiply or release toxins in the body. They can affect the skin, lungs, brain, blood, and other body parts. Most bacterial infections are not serious and can be treated with antibiotics. However, some can be life-threatening, especially if they get deep into the body or the patient has a weakened immune system.
To treat bacterial infections effectively, it is essential to identify the specific type of bacteria causing the infection. This is done by taking a sample of the body fluid suspected of being infected, such as blood, urine, saliva, sputum, or fluid from surgery. The sample is then cultured to encourage bacterial growth and determine its sensitivity to different antibiotics. The antibiotic that damages the bacterial sample the most is typically used for treatment.
In addition to antibiotics, patients are usually advised to get plenty of rest, maintain a healthy diet, and stay hydrated to encourage the body's natural healing process. Early detection and treatment are crucial in managing bacterial infections.
Hospital-acquired infections (HAIs) are a particular concern, with about 1 in 10 hospitalised patients contracting an HAI. The risk factors for HAIs include immunosuppression, older age, length of hospital stay, multiple underlying health conditions, and recent invasive procedures. HAIs can be prevented by strict adherence to infection control practices, such as handwashing, disinfecting hospital rooms, and proper use of invasive devices like catheters.
Some common bacterial infections include urinary tract infections (UTIs), food poisoning, sexually transmitted infections (STIs), skin infections, sinus infections, ear infections, and bacterial pneumonia. More severe infections can lead to sepsis, a life-threatening condition where the body damages its own tissues in response to the infection, resulting in organ failure and, potentially, death.
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Bacterial infections outside of the hospital
Bacterial infections can be contracted outside of a hospital setting. For example, Staphylococcus aureus, also known as "staph", is carried by approximately one-third of Americans in their noses. Most people are unaware that they are carrying the bacteria as it is harmless to healthy individuals. However, when staph enters a surgical incision or another part of the body, it can cause a serious infection such as pneumonia.
Another example is the bacteria that causes a Clostridioides difficile infection, or C. diff, which has a high rate of recurrence. C. diff is the most common hospital-acquired infection (HAI), causing about 500,000 infections each year in the United States. However, C. diff infections can also occur outside of the hospital setting.
In addition, Acinetobacter infections are rarely found outside of hospitals, but they can occur in individuals with severe illnesses requiring treatment in a critical care unit. These individuals are at risk of developing an Acinetobacter infection because their immune systems are compromised.
It is important to note that the risk of contracting a bacterial infection outside of a hospital setting depends on various factors such as the individual's overall health, their exposure to contaminated areas or environments with poor sanitation, and their contact with other individuals carrying bacterial infections. While hospital-acquired infections are a significant concern, it is also important to recognize that bacterial infections can be contracted in various settings and contexts.
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Frequently asked questions
About 1 in 10 people admitted to a hospital will contract a hospital-acquired infection (HAI). The risk of contracting an HAI depends on the facility's infection control practices, the patient's immune status, and the prevalence of pathogens within the community.
Common bacterial infections include food poisoning, skin infections, sexually transmitted infections (STIs), bacterial pneumonia, and urinary tract infections (UTIs).
Bacterial infections are often treated with antibiotics. Once the type of bacteria is identified, the antibiotic that damages the bacterial sample the most is typically used to treat the infection.
