Healthcare-associated infections (HAIs) are a growing concern for everyone impacted within the field of healthcare — both patients and providers. The Centers for Disease Control and Prevention believes that every day, one in 20 patients will contract an HAI. Equally disturbing, the economic burden of HAIs is suspected to reach over $30 billion a year.
Hospitals are the perfect environment for infections to manifest. Being isolated in a small area, day after day, with many other people who also have suppressed immune systems, understandably leaves patients highly susceptible to infection.
There are a number of patient safety networks and associations who have joined forces to improve infection control and lower the number of patients who contract these conditions.
Methicillin-resistant Staphylococcus aureus (MRSA) infections, norovirus, and Escherichi coli — these are just some of the better-known bacteria and viruses responsible for HAIs, according to Beckers Hospital Review.
MRSA — This is an often-talked about HAI because its severe antimicrobial resistance makes it difficult to treat. MRSA infections generally appear on the skin, but they can spread to organs and into the bloodstream, causing sepsis, pneumonia and surgical site infections. The bacteria are spread through direct contact, usually through an open wound or contaminated hands. Proper hand hygiene is considered the best defense against MRSA transmission.
Norovirus — The group of viruses known as norovirus is the most common cause of gastroenteritis. Healthcare facilities serve as the most favorable transmission spaces for the highly contagious virus, as the close quarters enable rapid person to person transmission. The virus has a prepotency to survive outside of a human host, with some studies finding the virus persisting for weeks on hard surfaces, 12 days on fabrics and even months in still water. Proper hand hygiene is an effective way to avoid transmitting norovirus.
Escherichia coli — E. coli is another bacteria group often found in the gut but can also become pathogenic. It is the leading cause of urinary tract infections in hospitals, but can also cause gastroenteritis, pneumonia or even neonatal meningitis. The E. coli bacteria has been in existence for an estimated 30 million years. E. coli is a very complex bacteria — only 20 percent of its genome is found in all strains — and some researchers suggest it should be taxonomically reclassified.
Nationally reported metrics indicate that the 5 most common causes of HAIs are as follows, beginning with the highest prevalence.
Pneumonia — Pneumonia is an infection of the lungs. Cough, shortness of breath and fever are some of the symptoms a patient may face. Most patients who are treated for pneumonia in a hospital are admitted with the infection (having acquired pneumonia in the community).
However, hospital-acquired pneumonia can occur especially in intensive care patients who require assistance with breathing (on a life support machine or ventilator). Pneumonia can be a severe infection and can sometimes be fatal.
Surgical Site Infection — A surgical site infection can occur when bacteria enters the cut made by the surgeon. This results in symptoms such as redness, swelling or pain at the site of the cut as the body tries to fight the infection.
Surgical site infections can be superficial (just affecting the skin) or more extreme (i.e. impacting the tissues or muscles under the skin). Surgical site infections due to germs cannot always be prevented. The likelihood of an infection depends on a number of factors related to both the patient’s general health at the time of surgery and the type / duration of surgery performed.
Gastroenteritis — Gastroenteritis is inflammation of the bowel caused by an infection. Symptoms include diarrhea, vomiting and abdominal cramps. Gastroenteritis is often picked up in the community and those affected (especially the older population and children) may be admitted to the hospital due to dehydration.
Hospital-acquired gastroenteritis is most commonly caused by Clostridium difficile and the winter vomiting bug (Norovirus). Norovirus is usually a mild illness. However, for a small number of patients, Clostridium difficile can be a severe infection and, in rare cases, can be fatal.
Urinary Tract Infection — Urinary tract infections (UTIs) occur when germs get into the urethra and travel up into the bladder. The urinary tract includes the kidneys (which filter the blood to produce urine), the ureters (the tubes that carry urine from the kidneys to the bladder), the bladder (which stores urine), and the urethra (the tube that carries urine from the bladder to the outside).
Patients who have a catheter inserted into the bladder to drain urine are more likely to develop a urinary tract infection. Symptoms of UTIs can include passing urine more frequently, urinating becomes painful, fever and chills. Catheter-associated urinary tract infections (CAUTI) are some of the most common HAIs.
Bloodstream Infection — A bloodstream infection often occurs when germs enter the blood. Patients with a catheter (drip) placed into a vein are more likely to get a bloodstream infection. Symptoms include fever, chills, general weakness, nausea and vomiting. These are very serious infections and can be fatal.
In the next edition of Auxo Medical’s newsletter and blog, we will review what industry advocates are doing to reduce the frequency of HAIs, and what can be done to prevent them.