Infections in hospitals. What every patient should know

Imagine, you went to a hospital seeking cure of your disease but instead acquired another infectious disease from the hospital. This is called hospital acquired or nosocomial infection. It is one of the biggest risk which a patient is exposed to while getting treated in a hospital. Every year about 17 million patients acquire nosocomial infections in United States which leads to 99,000 deaths every year (As per data of CDC). The figures in developing countries like India may be much higher.

Why does nosocomial infection occur?
Hospital is a place where, diseased patients come for treatment, majority of whom are suffering with some or other type of infections. So, along with them they bring their bacteria in hospital environment. These microbes transmit themselves through various means like staff clothing, air, handshakes, utensils etc. and infect other patients in hospital. Besides infections from others, bacteria present on patient's own body is a big source of infection. Various procedures in hospital like injections, Intra-venous medicine administration, surgeries, minor procedures, use of equipments etc. make it easy for bacteria to enter into a patients blood stream and cause infection

What type of infections are common?
Infection following a surgery, Pneumonia, Septicaemia (infection in blood), Urinary tract infections, diarrhoea and infections of mother and newborn are very common. Streptococcus, Staphylococcus, Helicobacter, E.Coli are few micro-organism who cause these infections.

What is the severity of these infections?
These infections may range from minor symptoms to severe infections resulting in deaths or disability. Usually nosocomial infection are tough to treat than general infections. A high level antibiotics may be required.

Which types of patients are at risk?
Although, all patients in hospital are at risk following types of patients are at greater risk of acquiring these infections
Patients whose immune system is weak, for eg. Patient infected with HIV, patients on immunosuppressive therapy
Patients on whom invasive devices are used like Intra-venous cannula, central line cannula, Urinary catheter
Patients on ventilator
Patients with surgical procedures
Patients with large wounds, burns, cuts etc.
Patients with loss of sensation on skin
Children
Elderly patients
Newborns and mothers

How to know if the patient acquired a nosocomial infection
If patient acquires nosocomial infection, you will notice symptoms of infection. The symptoms will be according to the type of infection acquired. In general symptoms may involve pus, swelling and pain over the site where surgery was performed, sore throat, pain and burning while urinating, fever etc.

These symptoms may occur even after discharge. In case you develope these symptoms within 7 days of discharge, you can suspect nosocomial infections.

Besides symptoms some change in treatment can also indicate that the patient may have acquired infections. These are,
If your stay have been prolonged than what initially planned and told by your doctor
If there have been a change the antibiotics prescribed to you
If your blood or pus sample is taken for laboratory test even after all investigations have been done
If you suspect, you can ask your doctor regarding possibility of nosocomial infection

What does hospitals do to prevent nosocomial infections
Good hospitals take lots of measures to prevent their patients from infection. A hospital is expected to maintain highest level of cleanliness and sanitation, follow correct sterilization procedures, wearing of gloves, masks, aprons by staff, training of staff on infection control, special care of patients who are at risk of acquiring infections etc. Many hospitals also calculate their infection rates and try to bring it down.
However, it is extremely difficult to eliminate nosocomial infection completely.

What should a patient do to prevent himself / herself
Patient should be aware of the fact that nosocomial infection can occur to him/her. He/she should take due care when in hospital. These include
Taking care of hygiene of patient by regular bath, sponging etc.
Complete compliance to medicine prescribed by doctor. Antibiotics, specially should be taken for the duration prescribed, even if symptoms get over
Avoid hand shake when in hospital (even with relatives who came to meet patient)
Ask hospital staff, if they have washed their hands, before touching you
Ask, if the item being used on patient have been appropriately sterilized
Ensure that your bed linen is changed daily with washed and clean ones
If you are in general ward or sharing room with other patients, see that there is sufficient distance between the beds. (Ideal recommendation for hospitals is to have minimum 6 feet distance between two beds)
If you are on catheter, see that some one from staff regularly monitors the area of your skin where catheter is inserted
See that the staff who bring food and neat and clean and uses gloves and caps while serving
Relatives should avoid crowding near patient.

In addition, you can ask about infection prevention strategies to your doctor or other staff of the hospital. They will guide you according to your situation.