Hospital Acquired Infections

2020 Sep 3. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan–.

ABSTRACT

Hospital-acquired infections, also known as healthcare-associated infections (HAI), are nosocomially acquired infections that are typically not present or might be incubating at the time of admission. These infections are usually acquired after hospitalization and manifest 48 hours after admission to the hospital. The infections are monitored closely by agencies such as the National Healthcare Safety Network (NHSN) of the Center for Disease Control and Prevention (CDC). This surveillance is done to prevent HAI and improve patient safety. HAI infections include central line-associated bloodstream infections (CLABSI), catheter-associated urinary tract infections (CAUTI), surgical site infections (SSI), Hospital-acquired Pneumonia (HAP), Ventilator-associated Pneumonia (VAP), and Clostridium difficile infections (CDI).

For the last few decades, hospitals have taken the hospital-acquired infections seriously. Several hospitals have established infection tracking and surveillance systems in place, along with robust prevention strategies to reduce the rate of hospital-acquired infections. The impact of hospital-acquired infections is seen not just at an individual patient level, but also at the community level as they have been linked to multidrug-resistant infections. Identifying patients with risk factors for hospital-acquired infections and multidrug-resistant infections is very important in the prevention and minimization of these infections.

Based on the guidelines from both the Infectious Disease Society of America (IDSA) and the American Thoracic Society (ATS), the definitions of Pneumonia have been changed to better identify patients at risk for multidrug-resistant (MDR) pathogens. This, in turn, is aimed at avoiding the overuse of antibiotics. Healthcare-acquired Pneumonia or HCAP, which was widely used previously, has been made obsolete. The term Hospital-acquired Pneumonia or HAP has replaced HCAP. As per the IDSA guidelines, Hospital-acquired Pneumonia is defined as "pneumonia that occurs 48 hours or more after admission to the hospital and did not appear to be incubating at the time of admission". According to IDSA, Ventilator-associated pneumonia or VAP is defined as "pneumonia that develops more than 48 to 72 hours after endotracheal intubation". Both HAP and VAP are associated with poorer outcomes and significant morbidity and mortality worldwide.

PMID:28722887 | Bookshelf:NBK441857