Nosocomiale

Nosocomial infections, also called hospital-acquired infections (HAI), are infections acquired in a hospital or other healthcare facility that were not present and not incubating at the time of admission. They are diagnosed after the patient has been admitted for 48 hours or after a procedure, and definitions vary by country and surveillance system. They can also be detected after discharge in some surveillance programmes.

The most common nosocomial infections include urinary tract infections, often related to catheter use; surgical site infections; pneumonia, including ventilator-associated pneumonia; and bloodstream infections, frequently related to intravascular lines. Multidrug-resistant pathogens, such as MRSA, ESBL-producing Enterobacterales, and Pseudomonas aeruginosa, contribute substantial risk.

Risk factors include the need for invasive devices (catheters, central venous lines, endotracheal tubes), major surgery, prolonged hospital stay, severe illness, immune suppression, prior antibiotic exposure, and gaps in infection prevention and control.

Prevention centres on robust infection prevention programs: strict hand hygiene, sterile technique, proper device management, sterilization and environmental cleaning, antimicrobial stewardship, vaccination of healthcare workers and patients where appropriate, and surveillance with rapid isolation of infected or colonized patients.

Nosocomial infections increase morbidity, mortality, length of stay, and healthcare costs. The term “nosocomial” is widely used internationally; in many settings, “hospital-acquired infection” is preferred. Surveillance and prevention remain central to reducing their incidence.