nosokomialen

Nosokomialen infections, commonly referred to as nosocomial or hospital-acquired infections, are infections that patients acquire during the course of receiving healthcare and were not present at the time of admission. They may appear in the hospital or within a short period after discharge, depending on the surveillance definitions used. These infections arise when a patient is exposed to infectious agents in healthcare settings, often in association with invasive procedures, devices, antibiotic exposure, or underlying illness. The most common sites are urinary tract infections, surgical site infections, bloodstream infections, and pneumonia.

Common pathogens include Staphylococcus aureus (including methicillin-resistant strains), Enterococcus faecalis and faecium, Escherichia coli, Klebsiella species, Pseudomonas aeruginosa, Acinetobacter species, and Clostridioides difficile. Many organisms exhibit antimicrobial resistance, complicating treatment and control.

Transmission occurs mainly via the hands of healthcare workers, contaminated equipment, and environmental surfaces; the use and management of invasive devices such as catheters and ventilators increase risk. Risk factors include longer hospital stays, surgery, critical illness, intensive care unit admission, prior antibiotic use, and immunosuppression.

Prevention focuses on infection control: rigorous hand hygiene, standard and contact precautions, sterilization and disinfection, environmental cleaning, vaccination where applicable, antibiotic stewardship, and prompt removal of unnecessary devices. Surveillance and reporting track infection rates (often per 1,000 patient-days) and device-associated infections like CLABSI, CAUTI, VAP, and SSI, guiding prevention efforts.

The impact is substantial, with higher morbidity and mortality, longer hospital stays, and increased healthcare costs. Reducing nosokomialen infections requires sustained organizational commitment and adherence to evidence-based practices.