People always have to visit the hospital seeking for treatment and solutions for their health problems. Unfortunately, if necessary precautions are not undertaken people may instead acquire other infections from their.

Such infections which are a result of treatment in a hospital or a healthcare service unit, but secondary to the patient’s original condition are called nosocomial. Infections are considered nosocomial if they first appear 48 hours or more after hospital admission.

People should understand that hospitals house large numbers of people who are sick and whose immune systems are often in a weakened state.

Increased use of outpatient treatment means that people who are in the hospital are worse off on average. Medical staff move from patient to patient, providing a way for pathogens to spread.

Many medical procedures bypass the body’s natural protective barriers. Sanitation protocol regarding uniforms, equipment sterilisation, washing, and other preventative measures may either be unheeded by hospital staff or too lax to sufficiently isolate patients from infectious agents. 

Additionally, patients are often prescribed antibiotics and other anti-microbial drugs to help treat illness; this may increase the selection pressure for the emergence of resistant strains.

Factors predisposing a patient to infection can broadly be divided into four areas; People in hospitals are usually already in a poor health state, impairing their defence against bacteria, and advanced age or premature birth along with immunodeficiency due to drugs.

Illness and irradiations present a general risk, while other diseases can present specific risks. For instance, chronic obstructive pulmonary disease can increase chances of respiratory tract infection.

Invasive devices; for instance intubations, catheters, surgical drains and tracheotomy tubes all bypass the body’s natural lines of defence against pathogens and provide an easy route for infection.

A patient’s treatment itself can leave them vulnerable to infection. For example immunosuppressant and antacid treatment undermine the body’s defences while antimicrobial therapy may remove competitive flora leaving only resistant organisms, and recurrent blood transfusions have also been identified as risk factors.

"Micro organisms are transmitted in hospitals by several routes, and the same micro organism may be transmitted by more than one route. There are five main routes of transmission; contact, droplet, airborne, common vehicle, and vector borne,” says Doctor Richard Munyaneza working at Rwikwavu district hospital.

Channels through which the germs can be transmitted are discussed as follows:

Contact transmission: the most important and frequent mode of transmission of nosocomial infections, is divided into two subgroups: direct-contact transmission and indirect-contact transmission.

Direct-contact transmission: involves a direct body surface-to-body surface contact and physical transfer of micro organisms between a susceptible host and an infected or colonised person, such as occurs when a person turns a patient, gives a patient a bath, or performs other patient-care activities that require direct personal contact.

Indirect-contact transmission: involves contact of a susceptible host with a contaminated intermediate object, usually inanimate, such as contaminated instruments, needles, or dressings, or contaminated gloves that are not changed between patients.

Droplet transmission: occurs when droplets are generated from the source person mainly during coughing, sneezing, and talking, and during the performance of certain procedures such as bronchoscopy.

Airborne transmission: occurs by dissemination of either airborne droplet nuclei (small-particle residue or smaller in size} of evaporated droplets containing micro organisms that remain suspended in the air for long periods of time) or dust particles containing the infectious agent. Special air handling and ventilation are required to prevent airborne transmission.

Common vehicle transmission: applies to micro organisms transmitted to the host by contaminated items such as food, water, medications, devices, and equipment.

Vector borne transmission: occurs when vectors such as mosquitoes, flies, rats, and other vermin transmit micro organisms.

Prevention

Isolation: Isolation precautions are designed to prevent transmission of micro organisms by common routes in hospitals.

Hand washing and gloving: hand washing frequently is called the single most important measure to reduce the risks of transmitting micro organisms from one person to another or from one site to another on the same patient.

Although hand washing may seem like a simple process, it is often performed incorrectly. Healthcare settings must continually remind practitioners and visitors on the proper procedure in washing their hands to comply with responsible hand washing.

Simple hand washing signals can assist healthcare facilities in the prevention of nosocomial infections. In addition to hand washing, gloves play an important role in reducing the risks of transmission of micro organisms. Gloves are worn for three important reasons in hospitals.

First, gloves are worn to provide a protective barrier and to prevent gross contamination of the hands when touching blood, body fluids, secretions, excretions, mucous membranes, and non intact skin; the wearing of gloves in specified circumstances to reduce the risk of exposures to blood borne pathogens or germs.

Secondly, gloves are worn to reduce the likelihood that micro organisms present on the hands of personnel will be transmitted to patients during invasive or other patient-care procedures that involve touching a patient’s mucous membranes and non-intact skin.

Thirdly, gloves are worn to reduce the likelihood that hands of personnel contaminated with micro organisms from a patient or a fomite can transmit these micro organisms to another patient.

In this situation, gloves must be changed between patient contacts and hands should be washed after gloves are removed.

Wearing gloves does not replace the need for hand washing, because gloves may have small, non-apparent defects or may be torn during use, and hands can become contaminated during removal of gloves. Failure to change gloves between patient contacts is an infection control hazard.

Contact: josephmunich06@yahoo.co.uk