Infections are caused by viruses, bacteria, or other microorganisms. Hospital-acquired infections, also called nosocomial infections, happen within a hospital. According to the CDC, 1 in every 31 patients can get hospital-associated conditions. Each year, the estimated number of infection cases is 1.7 million and accounts for 99,000 deaths per year. The amount of human suffering and financial loss due to these infections places an enormous burden on the healthcare system and patients.
32% of hospital-acquired infections are urinary tract infections, 22% are surgical site infections, 15% are lung infections, and 14% are bloodstream infections.
Catheter-associated urinary tract infections
Urinary tract infections (UTIs) are the most common type of hospital-acquired infection. 75% of UTIs are associated with the use of a urinary catheter. A urinary catheter is a soft tube installed to drain urine from the bladder when the bladder cannot be emptied the natural way.
There is a 15%-25% chance that you may receive a urinary catheterization during your stay in the hospital. This puts you at risk for a UTI. If left unaddressed, the infection can travel throughout other areas of the urinary system, including the kidneys, turning it into a more severe condition, the worst of which is sepsis, which can be life-threatening. Most UTIs can be treated with antibiotics.
Surgical site infections
Surgical site infections (SSIs) occur at the site where the surgery was performed. SSIs can involve only the skin, spread into the deeper parts of the skin, organs, or around implanted material. SSI develops in 1-3% of the patients who undergo a surgical procedure. An SSI may contain pus, have an odor, and be red, painful, and hot to the touch.
Infections can be treated with antibiotics, but they may develop into sepsis and spread throughout the body if left untreated. This is a life-threatening condition that can lead to medical emergencies and multiple organ failures.
The presence of bacteria at the site of surgery can lead to complications after the surgical procedure, even if sterilization procedures and protocols are followed by the hospital.
Complications associated with certain diseases like diabetes can also increase the risk for surgical site infection. After the surgery, the bacteria could multiply, triggering the body’s reaction and ultimately causing sepsis. It is still uncommon, occurring in less than 1% of patients.
Certain circumstances may put patients at higher risk for surgical site infections. The doctors must follow the infection control protocols and strategies to prevent disease. Moreover, while treating high-risk patients, doctors must take additional precautions and educate patients before and after the surgery on preventing infections.
Ventilator-associated pneumonia (VAP) is a complication a patient may get if placed on a ventilator. A ventilator is a machine that supplies breathable air in and out of the lungs through a tube. Pathogens can enter this tube and get into the lungs, causing a lung infection. Of all intensive care unit nosocomial pneumonia infections, 86% are VAP.
Common considerations to reduce the risk of ventilator-associated pneumonia:
- Whether to use intubation
- The placement of the intubation tube (know as an endotracheal tube)
- Proper feeding of the patient
- There is no secretion retention and inadequate cough
- The patient is not immunosuppressed
- There is no respiratory tract infection
- Good oral hygiene
- Proper positioning of the patient
- Preventing stress-related bleeding
- Proper use of antibiotics
The risk of developing an infection is higher in cancer and immunocompromised patients because it is easier for bacteria to invade the lung tissues. Intubation builds up oral and gastric fluid, which blocks airway clearance that forms bacterial colonies and gets transmitted into the lungs. Most of the bacteria causing hospital-acquired pneumonia are multidrug-resistant bacteria.
So whenever the infection occurs, it should be diagnosed as early as possible, and the doctor must choose the appropriate antimicrobial drug treatment to avoid later complications.
In case of any or all of the conditions mentioned above, when the bacteria from a site (e.g., lungs, skin, or urinary tract) enters the circulation via the bloodstream, it leads to a severe condition called septicemia or sepsis.
Once the bacteria enter the bloodstream, they are carried throughout the entire body. The body’s immune system releases chemicals into the blood, causing inflammation.
This can disrupt the blood flow to the organs and cause organ failure. There is no organ failure in many other cases, but there is the risk of increased blood pressure, decreased heart function, or septic shock.
Another type of bloodstream infection is central line bloodstream infection or catheter-associated bloodstream infection. This happens when a catheter tube is inserted into your bloodstream to draw blood or give you fluids or medications intravenously.
The bacteria can enter the body through the insertion point and eventually circulate in the bloodstream. Hemodialysis (a procedure for patients with kidney disease) may also introduce bacteria into the blood through the central line.
Catheter-related bloodstream infections have been reported in 3 to 8% of inserted catheters and are the first cause of nosocomial bloodstream infection in intensive care units (ICUs), with 80,000 cases annually.
Central line bloodstream infections can occur due to:
- Contamination on insertion site of the blood catheter
- The bacteria present on the patient’s skin
- A breach in infection control practices by a healthcare provider
- Colonization of bacteria on the central venous catheter tip
- Contaminated infusion or components of the IV set
- Spread through the bloodstream from other sites
- Non-intact dressing or open wounds
Infections are common with any medical or surgical procedure. Your healthcare provider’s responsibility is to maintain hygiene, use aseptic and sterile instruments, and accurately monitor urinary output.
To avoid bloodstream infections, it is crucial that the doctor maintains basic hygiene and follows all sterilization protocols. All healthcare providers must be educated about the procedures involved in using medical instruments.
It is almost impossible for anyone to determine when and where an infection started and where the bacteria came from, as an infection itself is not a deliberate occurrence initiated by a healthcare provider. Most of the time, the condition isn’t caused by a surgeon or medical team but by the bacteria.
The critical question then becomes, “did the medical staff respond appropriately to the infection and do everything within their standard practice to treat it?”.
If standards of care were not adhered to and you or your loved ones have suffered severe infections or an unfortunate incident like death, then you should speak to a qualified medical malpractice attorney.