nosokomialer

Nosokomialer, or nosocomial infections, are infections acquired in health care facilities during medical care. They are not present or incubating at the time of admission and are usually recognized 48 hours or more after admission or within 30 days after a surgical procedure, depending on the infection type and local policy. Common sites include urinary tract infections, surgical site infections, pneumonia—especially ventilator-associated pneumonia—and bloodstream infections often related to intravascular catheters.

Pathogens involved span a range of bacteria and fungi. Common culprits include Staphylococcus aureus and coagulase-negative staphylococci, Enterococcus, Escherichia coli, Klebsiella species, Pseudomonas aeruginosa, and Candida species. Many pathogens exhibit antibiotic resistance, such as MRSA, ESBL producers, and other multidrug-resistant organisms, which complicates treatment.

Risk factors for acquiring nosocomial infections include the use of invasive devices (urinary catheters, central venous catheters, endotracheal tubes), prolonged hospital or intensive care unit stays, recent surgery, prior antibiotic exposure, advanced age, and underlying immune suppression or comorbidities. These infections contribute to increased morbidity and mortality, longer lengths of stay, and higher health care costs.

Prevention and control focus on reducing transmission and device-related risks. Key measures include strict hand hygiene and aseptic technique, care bundles for central lines, urinary catheters, and ventilated patients, thorough environmental cleaning, antimicrobial stewardship, active infection surveillance, and appropriate isolation precautions when indicated.

Surveillance programs and guidelines from health authorities help track rates, identify outbreaks, and guide prevention efforts, reflecting the ongoing public health importance of reducing nosocomial infections worldwide.