Definition of Nosocomial Infection


A nosocomial infection refers to an infection acquired while in a hospital or healthcare setting.

Sometimes going to the hospital means you don't just get better, you might get an infection.

While a patient is admitted to the hospital for treatment of other conditions, nosocomial infections may be acquired from other patients, hospital staff, contaminated objects or solutions, or from the patient himself (such as transfer from one site of the body to another).

Most common nosocomial infections are surgical wound infections, urinary and respiratory tract infections, and bacteremia (bloodstream infections). Many of these infections are by antibiotic-resistant bacteria, known as superbugs, and can often have serious consequences for the individual and the hospital community.

How Infections Are Spread

Infections can spread from patient to patient, provider to patient, patient to provider, or even provider to provider. There are many ways to prevent these sorts of infections.This includes cohorting infectious patients and suspecting important contagious diseases rapidly before they are diagnosed. This also includes using gloves, masks, and other personal protective equipment to avoid infections spreading. In addition, this involves the careful selection of antibiotics - to prevent drug resistance or untreated infections spreading. It also involves vaccination of healthcare workers to prevent infections like Hepatitis B and the flu from spreading when these are vaccine-preventable.

Nosocomial infections have caused real problems. This can include drug resistant infections spreading in hospitals, like MRSA or CRE as well as many others. It can also include an infection that spreads from patient to patient in the context of antibiotic use (and over use) - like a nasty cause of diarrhea, C Diff.

Norovirus, which is a highly infectious gastrointestinalvirus, often causes outbreaks in hospitals. This has also included MERS and Ebola, as well as rare, but worrisome, infections like Crimean Congo Hemorrhagic Fever and Nipah Virus.

Avoid Spreading Infection

Healthcare workers work hard to prevent infections spreading within healthcare facilities.

There are many ways that health professionals can work to avoid spreading nosocomial infections.

  • One way is to avoid getting sick. This means being up to date on vaccinations for common illnesses. Influenza spreads in hospitals between patients, visitors, and staff. What might seem like a mild illness can be deadly to someone who is already sick - or to someone who is pregnant, as pregnant women are particularly at risk from influenza.
  • It also means being up to date on other vaccinations, like measles, chickenpox, mumps, and even rubella, so that if a rare infection became less rare, there wouldn't be any spread of these highly contagious diseases.
  • It also means staying away from a health facility when one is sick. Doctors and nurses often feel obliged to work
  • It means practicing good hygiene. This means washing hands before and after seeing patients. It also means coughing and sneezing into a handkerchief or an elbow - and not a hand.
  • Another way to protect against nosocomial infections is to avoid overusing antibiotics. The overuse of antibiotics can make patients particularly vulnerable to certain infections that spread when antibiotics are used, like CDiff. It can also create and select for antibiotic resistant bacteria. We all carry a lot of bacteria around with us; we don't want any of these bacterial strains to become resistant. Those who are already sick can be vulnerable to mild bacteria, which can be hard to stop when they don't respond to antibiotics.
  • Health professionals may use different forms of PPE, Personal Protective Equipment. This can include gloves, gowns, goggles, masks, aprons, and other materials worn to avoid a healthcare worker getting sick. This was seen during Ebola when many layers of PPE were used. It can however be wearing gloves and maybe a gown when working with a patient who has an infectious diarrhea. It can mean wearing a surgical mask and eye protection around a patient with a respiratory infection. It can mean wearing a special mask around a TB patient. The most difficult part sometimes is taking off PPE, as contagious material can be on the outside of gloves or other PPE material and contaminate someone as they are taking it off.
  • It also means stepping back from patients who might be infectious. Patients who have infectious diarrhea and infections that spread fecal-orally should not be touched without gloves or other protective gear and hand-washing should be employed. Patients who have infections spread by coughing and sneezing also do not need to be closely approached. No need to stand closer than a meter or two if a patient is coughing and sneezing and seems like he or she has a cold or the flu. Some infections - like TB, measles, and even chickenpox - are airborne and even more precautions should be taken and patients should not be closely approached without a mask. The health worker can go back and put on PPE appropriately.

Pronunciation: no-suh-COH-mee-ul in-FEC-shun

Also Known As: hospital- or healthcare-acquired infections



Public Health England