ABSTRACT
Nosocomial infection(s) (NI), which are commonly called hospital-acquired infection(s) (HAIs) or in this chapter, hospital-borne disease(s), have existed as major overall concerns in the health-care industry and community since the inception of antibiotics. Rates of these infections are increasing along with severity and complications. A rise in antibiotic resistance, including multiple resistances, has magni‚ed the effects of nosocomial diseases. Today, NIs are not only impacting patients in hospitals and other facilities but health-care workers (HCWs) as well. As organisms become more resistant, issues related to NIs will become greater and more acute. Microbial resistance is resulting in the need for more complex treatments and increased costs. Aspects of NIs are also being magni‚ed by the “types” of patients affected in hospitals and related institutions as compared to the past. NIs now extend beyond the traditional hospital setting and include community and ambulatory settings as well. Also, as patients spend more time convalescing at home, many of the risks associated with NIs are now seen in the home environment and other locations. Today, resistance is no longer contained to bacteria and is also
Summary ..................................................................................................................77 Introduction .............................................................................................................. 78 Hand Washing .......................................................................................................... 81 Infection Risk ........................................................................................................... 82 Creation of Antibiotic-Resistant Organisms ............................................................84 Nosocomial Infection Sites ......................................................................................85 Routes and Sources of Infection ..............................................................................88 Prevention of Nosocomial Infections .......................................................................90 Hepatitis ...................................................................................................................93 Nutrition and Probiotics ...........................................................................................95 Conclusion ...............................................................................................................96 References ................................................................................................................96
occurring in other microbes such as fungi and/or viruses. Therefore, these changes are impacting patient health along with HCWs. Because the cost containment is a major issue in health care, the rise in NIs will have a negative impact on the ‚nancial stability of many institutions. These issues and concerns have resulted in a greater effort to minimize NIs. Emphasis is now being placed on effective and ef‚- cient cleaning techniques (disinfection), hand washing, and monitoring practices. Also, increased rates of vaccination have helped minimize some NIs in HCWs and patients, as seen with hepatitis B vaccination. However, currently there are some agents for which no vaccination or cure exists (e.g., hepatitis C). Understanding the ecology of these infections will also assist in the reduction of NIs as seen in the application of probiotics.
