Going to the hospital, the last thing a person expects is to find a new disease here, instead of getting rid of an existing one.. In the meantime, this sometimes happens.. Infectious diseases that a person gets sick while in a medical institution are called nosocomial or hospital infection.. Both patients and employees of medical institutions get sick with it, and this happens much more often than we would like.. In fact, nosocomial infections are one of the main problems of medical institutions around the world..

Where does the nosocomial infection come from? Actually, where does the infection come from in the place where sick people are constantly admitted?. Another thing is not entirely clear - why it is not destroyed there, but remains, and even spreads. There are several reasons:.

The emergence of resistant strains of microbes as a result of improper use of antiseptics;

Insufficient technical equipment of the hospital: cramped rooms, poor or faulty ventilation, failed plumbing, outdated sterilization devices, etc..

The lack of middle and junior medical personnel, simply the lack of hands necessary to maintain the proper level of cleanliness;

Lack of antiseptic medicines or their poor quality;

Incorrect zoning of the hospital, when patients with infectious diseases, or rooms with an increased infectious risk, are not well isolated from the rest;

Neglect of hygiene rules, both on the part of medical personnel and on the part of patients and their visitors.

What pathogens most often survive in a hospital environmentThe causative agents of nosocomial infection are somewhat different from the usual microflora. They are characterized by increased aggressiveness, pathogenicity, resistance and ability to long-term survival.. Hospital infection is represented by a wide range of microorganisms, bacteria, viruses and fungi, the following microbial families are most common:.

Staphylococci;

streptococci;

Escherichia, especially E. coli;

Salmonella;

Klebsiella;

Protea;

Enterobacter;

Herpes, influenza, adenovirus infection, hepatitis viruses;

Enteroviruses;

Rotaviruses;

Cytomegaloviruses;

Yeast-like fungi;

Molds;

radiant fungi.

The dominant diseases caused by nosocomial infection are pneumonia (37%), urinary tract infections (23%), bacteremia caused by catheterization (catheter-associated bacteremia, 12%).

Who is most at risk The spread of nosocomial infection, of course, primarily depends on the department of the medical institution. It is quite obvious that in the neurological and cardiology department the risk of infection is lower than in the infectious or burn department, but in no department is it completely excluded..

Not all patients are equally vulnerable to germs. People with a weakened immune system are at risk: the elderly, premature and debilitated children, patients with oncological, endocrine, hematological, allergic and other immune diseases, lung diseases, metabolic disorders, who have undergone major operations, who have been in hospital for a long time, and who are bedridden..

Dangerous procedures Some manipulations are more dangerous than others in terms of the possibility of contracting a nosocomial infection.. The risk is especially high when carrying out the following procedures:.

Taking blood;

Venesection (manipulations associated with a violation of the integrity of the patient's veins);

Puncture;

sounding;

Endoscopic procedures;

Injections;

Transfusions (transfusion of drugs or blood);

Operational interventions;

Intubation;

Inhalation anesthesia;

Artificial lung ventilation;

catheterization;

Hemodialysis.

As can be seen from the above list, almost all therapeutic and diagnostic manipulations associated with penetration into the internal environment of the body are somehow associated with an increased risk of infection, and therefore require a highly responsible approach on the part of medical personnel..

The most infectiously dangerous medical instruments and devices. In it, all medical devices are divided into three groups - critical, semi-critical and non-critical.. Critical ones are those in the use of which the risk of infection is as high as possible, and therefore they must be sterilized. Semi-critical items may not be sterilized, but must be thoroughly disinfected. Non-critical enough to just be clean.

Critical items: surgical instruments, endoprostheses and implants, needles and injection systems, catheters and all fluids that are administered parenterally (into the bloodstream);

Semi-critical: equipment for anesthesia, inhalation, endoscopes, rectal thermometers, enemas tips - that is, that which comes into contact with mucous membranes;

Non-critical items include all items in contact with the skin, such as blood pressure cuffs, thermometers, crutches, bedding, dishes, bedpans, etc..

How to deal with nosocomial infection In order to successfully resist nosocomial infection, the risk of which will always be present in hospitals, medical personnel must carefully adhere to the instructions developed for all therapeutic and diagnostic manipulations.. Protective equipment should not be neglected: masks and disposable gloves that are constantly put on and taken off, although they are very tiring and not always convenient, can save life and health, and not only for the health worker himself. Also, all medical personnel must undergo annual preventive examinations, since they are all at high risk..

Patients should follow that part of the safety rules that depends on them.. This includes following basic hygiene rules, strictly following the recommendations of the attending physician, as well as refraining from the thoughtless use of antibacterial drugs.. Unfortunately, a very common self-medication with antibiotics, in the overwhelming majority of cases incorrect, leads to the growth of resistant microflora.. The emergence of such resistant flora makes the existing antibacterial agents ineffective and causes a constant need for new, more and more powerful antibiotics..

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