Infectious and Rare Diseases

Detection and preventing infections in healthcare

Healthcare-associated infections are a threat to patient safety. Hospitalization for an acute illness, trauma, chronic care, or other health care conditions is a common occurrence. There were 39.2 million hospital discharges in 2005, with an average length of stay of 4.6 days. Hospitalization brings associated risks, including risk of infection. Nosocomial infections, or hospital-associated infections, are estimated to occur in 5 percent of all acute care hospitalizations, or 2 million cases per year. Hospital-associated infections have been identified as one of the most serious patient safety issues in health care. Infections that become clinically evident after 48 hours of hospitalization are considered hospital-associated. Risks factors for hospital-associated infections are generally categorized into three areas: iatrogenic, organizational, or patient-related. Iatrogenic risk factors include invasive procedures (e.g., intubation, indwelling vascular lines, urine catheterization) and antibiotic use and prophylaxis. Organizational risk factors include such things as contaminated air-conditioning systems, contaminated water systems, staffing (e.g., nurse-to-patient ratio), and physical layout of the facility (e.g., open beds close together). Examples of patient-related risk factors include severity of illness, immunosuppression, and length of stay.