A nosocomial infection is an infection that a patient contracts as a result of a stay or treatment in
- a hospital,
- a care facility or
- a rehabilitation clinic
has contracted. In most cases (71 percent), such hospital infections are caused by bacteria. Many of these bacteria are multi-resistant, meaning that standard antibiotics are ineffective against them. However, viruses (21 percent) and, in rare cases, fungi and parasites can also cause nosocomial infections.
As these pathogens are mainly found in hospitals, they are also referred to as hospital germs.
The consequences of such an infection with hospital germs are often serious. Due to their resistance, the germs and thus the inflammation can spread quickly in the body. This is often faster than the simultaneous search for the causative pathogen and an antibiotic to which the pathogen is not resistant.
A nosocomial infection can
- severe courses of the disease,
- amputation of the infected limb or even life-threatening
- even life-threatening conditions of the patient.
result.
In order to be able to speak of a nosocomial infection, it must be proven that the patient actually contracted the infection in hospital. They must have been demonstrably free of the pathogen before their stay.
A nosocomial infection is present if it is detected at least 72 hours after the patient's admission.
Consistent hygiene measures could prevent many nosocomial infections © auremar | AdobeStock
According to a study published by the Robert Koch Institute (RKI) in 2012, by far the most common hospital infections in German hospitals include
- post-operative wound infections,
- urinary tract infections,
- respiratory tract infections and
- blood poisoning (sepsis).
24.7 percent of cases of nosocomial infections are wound infections following surgical procedures. 22.4 percent are urinary tract infections caused by a urinary catheter. At 21.5 percent, lower respiratory tract infections take third place in the frequency of hospital-acquired infections. The most common and most feared respiratory infection due to its high mortality rate is pneumonia.
Blood poisoning (sepsis) accounts for 6 percent of cases of hospital-acquired infections.
The most common and most dangerous hospital germ in Germany is the bacterium Staphylococcus aureus. This bacterium is resistant to the antibiotic methicillin and other common antibiotics. This is why it is usually referred to as methicillin-resistant Staphylococcus aureus - MRSA for short .
MRSA can cause serious to fatal
- wound infections,
- respiratory tract infections,
- infections of the urinary tract and
- urinary tract infections and blood poisoning.
Due to its resistance to most antibiotics, these infections are difficult to treat.
Other important hospital germs include
- enterobacteria,
- the enterococci,
- the bacterium Pseudomonas aeruginosa and
- the Acinetobacter bacteria.
Enterobacteria
Enterobacteriaceae are part of the normal human intestinal flora. However, they pose a great danger to people with a weak immune system. In hospital patients, they can cause, among other things
- Intestinal and urinary tract infections,
- blood poisoning and
- inflammation of the lung tissue
lung tissue. The most important representative of enterobacteria is the bacterium Escherichia coli.
Enterococci
Enterococci also colonize the intestinal flora of many healthy people. They are also found in many foods due to their positive influence on the human intestinal flora.
In immunocompromised people, however, enterococci can cause dangerous
- intestinal infection,
- urinary tract infections,
- blood poisoning or
- endocarditis
endocarditis.
Enterococci include, for example, the bacterium Enterococcus faecium.
Many enterococci are resistant to the antibiotic vancomycin. This is why they are also referred to as vancomycin-resistant enterococci - VRE for short.
Pseudomonas aeruginosa
The bacterium Pseudomonas aeruginosa is mainly found in moist environments such as
- tap water,
- washbasins,
- showers or
- toilets
toilets. It is responsible for around ten percent of nosocomial infections in Germany. This makes this bacterium one of the most common hospital germs.
Among other things, it triggers
- purulent pneumonia,
- urinary tract infections,
- wound infections,
- blood poisoning,
- meningitis and
- intestinal infections
from.
Acinetobacter bacteria
Bacteria of the Acinetobacter genus, such as Acinetobacter baumannii, are increasingly developing resistance to common antibiotics. They are therefore increasingly leading to hospital infections in immunocompromised patients.
Respiratory patients in intensive care units are particularly affected. The bacterium often triggers pneumonia in these patients.
Other possible consequences of an infection with Acinetobacter bacteria are
- Blood poisoning,
- meningitis and
- wound infections.
Hospital germs can be transmitted in three different ways: Through
- Direct skin contact,
- transmission via a contaminated surface, or
- through the air.
The most common transmission route is direct contact with contaminated skin. In this way, multi-resistant pathogens pass directly from one patient to the next. Transmission from one patient to doctors or nursing staff and from there to another patient is also possible.
This can happen, for example, when bandages are exchanged or a catheter is inserted in another patient.
In most cases, transmission occurs via the hands. This is why consistent hand disinfection is the most important preventative measure in the fight against hospital germs.
Transmission via contact with contaminated objects or surfaces is known as environmental or cross-contamination. Prevention includes
- Consistent cleaning with disinfectants and
- the disposal of contaminated objects and surfaces.
are used.
Airborne transmission is also referred to as droplet infection. The germs get onto
- surfaces,
- objects or
- substances and
- directly to other people.
The most important preventative measure against such transmission is to wear a face mask.
The spread of multi-resistant hospital germs has been steadily increasing in recent years. Nosocomial infections are therefore a serious problem.
One reason for this increase is the overuse of antibiotics. Antibiotics were long regarded as a panacea and were prescribed unnecessarily often and also administered inappropriately.
Hospital germs such as MRSA or VRE are gradually becoming resistant due to the high consumption of antibiotics in hospitals. They therefore develop defense strategies against one or more antibiotics. This medicine then no longer helps against these germs.
Another important factor in the spread of hospital germs is a lack of hygiene in hospitals. For example, doctors and nursing staff do not disinfect their hands often enough, which means that they inadvertently transfer germs from one patient to another. Carelessness when cleaning and disinfecting potentially contaminated objects also encourages transmission.
There are also high-risk patients who are particularly susceptible to hospital germs. They have an increased risk of contracting a nosocomial infection in a hospital.
These high-risk patients include patients
- who are in an intensive care unit,
- are on artificial respiration,
- are receiving antibiotics or drugs that suppress the immune system and
- cancer patients,
- diabetics,
- dialysis patients and
- people with chronic wounds or skin diseases.
Advanced age also favors the infection of a patient with hospital germs.
How many hospital infections occur in Germany every year?
Exact figures on the frequency of hospital infections in Germany are not available, as there is no reporting obligation. However, a study published by the Robert Koch Institute (RKI) in August 2012 provides a figure. According to this, 3.33 percent of all patients treated in German hospitals become infected with hospital germs during their stay.
According to estimates by the Federal Ministry of Health, this amounts to 400,000 to 600,000 people every year. Around 15,000 of these people die as a result of the infection.
According to hygiene experts, many of these serious illnesses could be avoided. To do this, hygiene measures to combat multi-resistant hospital germs would have to be consistently observed.
What costs are caused by hospital-acquired infections?
Hospital-acquired infections cause costs of 2.5 billion euros in Germany every year. They therefore represent a considerable cost factor for the German healthcare system.
They are also associated with significant economic losses for hospitals. The facilities have to bear additional costs of 4,000 to 20,000 euros per nosocomial infection.
These additional costs are caused on the one hand by the longer hospital stays and care times. A patient infected with hospital germs stays in hospital an average of four days longer, depending on the type of infection. Secondly, the additional costs result from the additional expenditure required for diagnostic and therapeutic measures.
How can infections with hospital germs be prevented or reduced?
Improving hygiene in German hospitals is the most important preventive measure. A new Infection Protection Act was therefore passed in 2011. It requires compliance with binding hygiene regulations in hospitals. These hygiene regulations include, in particular, the consistent implementation of standard hygiene measures by hospital staff.
The measures for hospital staff include
- washing hands with disinfectant after every patient contact,
- wearing gloves and mouth and nose protection when coming into contact with body fluids,
- consistently cleaning surfaces and objects with disinfectants.
There are also other measures to improve hygiene in hospitals. For example, all hospital staff should attend regular training courses on hygiene and infection prevention. Hospitals should employ at least one specialist in hygiene and environmental medicine or a hygiene specialist in hospitals with 300 beds or more.
In addition, antibiotics should be used more moderately. This results in less resistance, so that nosocomial infections can be treated more effectively.
Screening high-risk patients before they are admitted to hospital can also help. The purpose of this measure is to identify and isolate people who are already carrying a hospital germ. Patients at risk are examined in advance for existing infections by taking a swab of the nasal mucosa or throat. If the test result is positive, they are placed in isolation.
These high-risk patients include people
- who have open wounds,
- live in a care facility or
- have already spent more than three days in hospital in the past year.
What devices are available to prevent or reduce hospital germs?
With the help of room air disinfection, it is possible to effectively reduce or eliminate hospital germs. This helps to prevent nosocomial infections.
Special hygiene systems add disinfectant substances to the air in hospitals via the ventilation systems. These kill off existing germs and pathogens and offer lasting protection against the colonization of new pathogens.
For this purpose, a special disinfection and room air freshening system is connected to the hospital's ventilation system.
These systems can also add fragrances to the air, which contribute to air freshening and a pleasant room climate.
