Cross infection: what it is, how to control it and the most common types

Hospital infection, or Health Care Related Infection (HAI) is defined as any infection acquired while the person is admitted to the hospital, and may still manifest during hospitalization, or after discharge, as long as it is related to hospitalization or hospitalization. procedures performed at the hospital.

Acquiring an infection in the hospital is not uncommon, as this is an environment where many people are sick and being treated with antibiotics. During the period in a hospital, some of the main factors that cause the infection are:

• Imbalance in the bacterial flora of the skin and body, usually due to the use of antibiotics; Fall in the defense of the immune system of the hospitalized person, both due to the disease and the use of medications; Carrying out invasive procedures such as catheter insertion, catheter insertion, biopsies, endoscopies or surgery, for example, that break the skin's protective barrier.

Generally, the microorganisms that cause hospital infection do not cause infections in other situations, as they take advantage of the environment with few harmless bacteria and the drop in the patient's resistance to settle. Despite this, hospital bacteria usually develop serious infections that are difficult to treat, since they are more resistant to antibiotics, so in general, it is necessary to use more potent antibiotics to cure this type of infection.

How control is done

In Brazil, the Ministry of Health and ANVISA determine that every health care environment must have certain precautions to prevent nosocomial infection. In the hospital, there must be a Hospital Infection Control Commission (CCIH), which corresponds to a group formed by health professionals whose function is to elaborate studying the epidemiological characteristics of the hospital and to elaborate a Hospital Infection Control Program with the objective of reduce as much as possible the number of infections acquired in the hospital, as well as the rate of multi-resistant microorganisms.

The CCIH is adequate according to the characteristics of the hospital and its needs, the main activities being carried out by this committee:

• Development of rules and routines for cleaning and disinfecting environments, establishing the frequency and type of disinfectant, especially in critical areas, such as nurseries, operating rooms or ICUs, for example; Determination of rules for patients, visitors and professionals, to reduce the risk of infections, such as limiting the number of visitors, establishing rules and training for hygiene, collecting exams, applying medications, performing dressings or preparing food, for example; Stimulation of hygiene measures, mainly of the hands, which are one of the main vehicles for the transmission of microorganisms, with frequent washing, or with the use of alcohol gel. Hand washing measures must be implemented both for the patients' companions and for the medical team, and monitoring of this practice is important; Guidelines for the correct use of antibiotics, preventing patients from being treated with antibiotics unnecessarily or by broad-spectrum antimicrobials, thus preventing the development of multi-resistant bacteria. See how the use of inappropriate antibiotics is the source of superbugs and how to treat them; Guidance on the use of chemicals to eliminate microorganisms, such as germicides, disinfectants, antiseptics, cleaning agents; Carrying out surveillance of infection cases, to understand the causes and develop forms of prevention.

To decrease a hospital's infection rate, basic care must be taken with all patients, regardless of their diagnosis and treatment. In addition, it is important to encourage hospital discharge whenever possible, avoiding staying in the hospital for a long time, as the chances of infection increase over time.

The activities performed by the CCIH are carried out with the main objective of promoting patient safety through measures aimed at reducing the risk of infection of the patient, such as, for example, raising awareness of companions and medical staff about the correct hand hygiene. Learn how to wash your hands properly.

Types of nosocomial infection

Hospital infection can be acquired in several places on the body, the most common types being:

1. Pneumonia

Hospital-acquired pneumonia is usually severe, and more common in people who are bedridden, unconscious, or who have difficulty swallowing, due to the risk of aspiration of food or saliva. In addition, people who use devices that assist breathing are more likely to acquire hospital infection. Some of the most common bacteria in this type of pneumonia are Klebsiella, Enterobacter, Pseudomonas, Acinetobacter, Staphylococcus aureus, Legionella, Mycoplasma , in addition to some types of viruses.

Main symptoms: The main symptoms associated with hospital pneumonia are chest pain, cough with yellowish or bloody discharge, fever, tiredness, lack of appetite and shortness of breath.

2. Urinary infection

Hospital urinary tract infection is facilitated by the use of a probe during the hospital stay, although anyone can develop it. Some of the bacteria most involved in this situation include Escherichia coli , Proteus sp., Pseudomonas aeruginosa, Klebsiella sp., Enterobacter sp., Enterococcus faecalis and fungi, such as Candida sp .

Main symptoms: Urinary tract infection can be identified by pain or burning when urinating, abdominal pain, presence of blood in the urine and fever.

3. Skin infection

Skin infections are very common due to the application of injections and venous access to medications or exam samples, surgical or biopsy scars or the formation of bedsores. Some of the microorganisms involved in this type of infection are Staphylococcus aureus, Enterococcus, Klebsiella sp., Proteus sp., Enterobacter sp, Serratia sp., Streptococcus sp. and Staphylococcus epidermidis , for example.

Main symptoms: In case of skin infection, there may be an area of ​​redness and swelling in the region, with or without the presence of blisters. Generally, the site is painful and hot, and there may be a production of purulent and smelly secretion.

4. Blood infection

Bloodstream infection is called septicemia and usually arises after infection in some part of the body, which spreads through the bloodstream. This type of infection is serious, and if not treated quickly it can quickly cause organ failure and risk of death. Any of the microorganisms from infections can spread through the blood, and some of the most common are E. coli , Staphylococcus aureus, Staphylococcus epidermidis or Candida, for example.

Main symptoms: The main symptoms related to the infection in the blood are fever, chills, drop in pressure, weak heartbeat, drowsiness. Learn how to identify the infection in your blood.

There are also several other less common types of hospital infections, which affect various regions of the body, such as the oral cavity, digestive tract, genitals, eyes or ears, for example. Any hospital infection must be quickly identified and treated with appropriate antibiotics, to prevent it from becoming serious and endangering the person's life, so in the presence of any sign or symptom of this situation, the responsible physician should be reported.

Who is most at risk

Anyone can develop a hospital infection, however those with greater immunity fragility are at greater risk, such as:

• Elderly; Newborns; People with impaired immunity, due to diseases such as AIDS, post-transplant or using immunosuppressive drugs; Diabetes mellitus poorly controlled; People bedridden or with altered consciousness, as they have a higher risk of aspiration; Vascular diseases, with impaired circulation, since it hinders oxygenation and tissue healing; patients in need of invasive devices, such as urinary catheterization, insertion of venous catheter, use of ventilation by devices; performing surgeries.

In addition, the longer the hospital stay, the greater the risk of acquiring a hospital infection, as there is a greater chance of exposure to the risks and responsible microorganisms.