BlessWorld Foundation International

Affecting the World Through Health
A Global Health Initiative

Healthcare Associated Infections



According to World Health Organization (WHO), healthcare associated infections (HCAIs)constitute a significant public health burden with about 15% of hospitalized patients affected- leading to an increase in morbidity, mortality and healthcare costs. Also known as nosocomial infections, healthcare associated infections are regarded as infections that occur within 48 hours of hospital admission, 3 days of discharge or 30 days of an operation. HCAIs pose serious problems because the organisms implicated are usually drug resistant, the most common ones being methicillin resistant staphylococcus aureus (MRSA) and multi-drug resistant gram negative bacteria.

Given to the presence of several risk factors, intensive care unit (ICU) patients are by far the most affected group by nosocomial infections. The risk factors associated with HCAIs include:

  1. Health status: Since most patients are exposed to similar conditions, the current health status and immunity of a patient determines the risk of infection of particular patients. Some vulnerable and immune-compromised patients may be malnourished or elderly.
  2. Invasive procedures: Some hospital procedures, especially surgery, involves the use of materials like catheters, lines and drains which when left for a long time can serve as a nidus for infection
  3. Treatment: Some treatment modalities can pose risk to infection e.g. blood transfusion, hemo-dialysis and immunosuppressive treatments
  4. Poor and unhygienic hospital practices: Poor sanitation and improper disposal of hazardous healthcare wastes can expose patients to infectious pathogens. Also, healthcare workers could play a role as vectors of infectious agents when they fail to take standard precautions.

Perhaps, the most important historical guide on addressing HCAIs was by the Hungarian physician- Ignaz Semmelweiz, who demonstrated that hand washing drastically reduced the incidence of puerperal fever in childbearing women. Even though his teachings were not accepted by physicians at that time, it laid the foundation for antisepsis. Till today, regular and proper hand washing remains the single most important measure in infection control. Proper hand washing should involve the use of alcohol disinfectants or medicated soap after removal of jewellery like watches, rings and should not be replaced with gloving. Hospitals should provide more wash sinks and easier to use disinfectants like sprays to encourage regular hand washing. To improve hygiene in general, healthcare facilities should provide enough personal protective materials such as overalls, gloves and nose masks which must not be reused. Also, healthcare workers must endeavour to engage in regular daily cleaning of stethoscopes with alcohol and observing complete aseptic procedure in invasive procedures to reduce the risk of infection.

In addition, it is pertinent that the healthcare system ensures enlightenment of caregivers and students alike on the importance of standard precautions of everyday practice in reduction of nosocomial infections. Also, there must be proper disposal of hazardous healthcare wastes which can harbour dangerous infectious organisms that are drug resistant. The related problem of antimicrobial resistance can then be reduced by good antimicrobial stewardship.

Comments are closed.