A hospital acquired infection (HAI), also known as a nosocomial infection, is an infection that is acquired in a hospital or other health care facility. It is sometimes called a health care associated infection (HAI or HCAI). Such an infection can be acquired in the hospital, nursing home, rehabilitation facility, outpatient clinic, or other clinical settings. About 6% of patients acquire an infection in hospital, and the incidence of hospital-acquired infections may be increasing.

Infection is spread to the susceptible patient in the clinical setting by various means. Health care staff can spread infection, in addition to contaminated equipment, bed linens, or air droplets. The infection can originate from the outside environment, another infected patient, staff that may be infected, or in some cases, the source of the infection cannot be determined.

Microorganisms may originate from a patient’s own skin microbiota, becoming opportunistic after surgery or other procedures that compromise the protective skin barrier. Though the patient may have contracted the infection from their own skin, the infection is still considered nosocomial since it was developed in the health care setting.

Some organisms that can cause HIA may include:

  • Staphylococcus aureus.
  • Methicillin resistant Staphylococcus aureus.
  • Pseudomonas aeruginosa.
  • Acinetobacter baumannii.
  • Stenotrophomonas maltophilia.
  • Clostridium difficile.
  • Escherichia coli.


Common of types HIA:

  • Hospital-acquired pneumonia.
  • Ventilator-associated pneumonia
  • Urinary tract infection
  • Gastroenteritis
  • Puerperal fever
  • Vancomycin-resistant Enterococcus.
  • Legionnaires’ disease



Causes of HIA:

  • Vector borne transmission; this is the transmission of microorganisms by vectors, such as mosquitoes, flies, rats, and other vermin.
  • Common vehicle transmission; this is the transmission of microorganisms to the host by contaminated items, such as food, water, medications, devices, and equipment.
  • Exposure to droplets: this occurs when droplets containing microbes from an infected person are propelled through the air in a short distance, and deposited on the patient’s body. These droplets generated from the source person may include; coughing, sneezing, and talking, and during the performance of certain procedures, such as bronchoscopy.
  • Transmission might be the result of effective contact, as in the cases of aureus , K. pneumoniae or rotavirus.


Symptoms of HIA:

  • Reintubation
  • Genetic syndromes
  • Immunodeficiency,
  • Bladder catheterization
  • Prior antibiotic therapy
  • Cerebral palsy
  • Fever, cough, purulent sputum
  • Abnormal chest auscultatory findings (e.g. decreased breath sounds, crackles, wheezes)
  • Fever or normal temperature
  • Tenderness, suprapubic (cystitis) or costovertebral (pyelonephritis)
  • Cloudy, foul-smelling urine



  • Sound infection control practice and prudent antibiotic use will reduce antimicrobial-resistant organisms and hospital-acquired infections.
  • Short hospital stays.
  • Sterilize hospital equipment and surfaces to kill all microorganisms, through exposure to chemicals, ionizing radiation, dry heat, or steam under pressure.
  • Maintain Isolating precautions designed to prevent transmission of microorganisms by common routes in hospitals.
  • Wash your hands as promptly and thoroughly as possible between patient contacts and after contact with blood, body fluids, secretions, excretions, and equipment or articles contaminated by them.
  • Gloves should be worn to provide a protective barrier for personnel, prevent large scale contamination of the hands when touching blood, body fluids, secretions, excretions, mucous membranes, and non-intact skin.
  • Sanitize surfaces with modern sanitizing methods such as Non-flammable Alcohol Vapor in Carbon Dioxide systems (it has been effective against gastroenteritis), MRSA, and influenza agents.
  • Avoid touching surfaces commonly found in hospital rooms, such as bed rails, call buttons, touch plates, chairs, door handles, light switches, grab rails, intravenous poles, dispensers (alcohol gel, paper towel, soap), dressing trolleys, and counter and table tops. They are known to be contaminated with Staphylococcus.
  • Obey the hospitals sanitation protocols regarding uniforms, equipment sterilization, hand washing and other preventive measures.
  • Thorough hand washing or use of alcohol rubsby all medical personnel before and after each patient contact is one of the most effective ways to combat nosocomial infections.
  • More careful use of antimicrobialagents, such as antibiotics, is also considered vital.
  • Bloodstream infection can be prevented by using catheter disinfection caps.




  • Infections of the Bloodstream are treated by removing the IV Line when appropriate, the patient is given antibiotics to treat gram positive and gram negative organisms. Anti-viral and anti-fungal therapies are also administered if appropriate for the condition.
  • Patients who are immune deficient are administered empirical doses of broad spectrum antibiotics initially, which can be later adjusted based on the pathogen determined. Special attention is given to multi drug resistant pathogens. Patients who are immune-deficient, or are symptomatic or have chronic lung disease are given anti-virals to protect them from influenza.
  • In the case of urinary tract infection, catheters should be removed, if possible, so that there is no recurrence of the infection. This can help in resolution of some types of infection.
  • For surgical site infection, care should be taken both surgically. Antibiotic can be changed once the pathogen is determined. B if a patient is suffering from streptococcal gangrene or tissue necrosis, aggressive intervention would be required.
  • In case of gastroenteritis caused by rotavirus, supportive care should be given to ensure there is no dehydration.
  • For severe diarrhea, metronidazole can be given.


Article by: eDokita Team.


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