Nosocomial infections and their control strategies
Nosocomial infections and their control strategies
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DOI：
10.1016/j.apjtb.2015.05.001
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发表时间：
2015-07-01
影响因子：
1.7
通讯作者：
Mehboob, Riffat
中科院分区：
文献类型：
--
作者：
Khan, Hassan Ahmed;Ahmad, Aftab;Mehboob, Riffat
医院感染也称为医院获得性/相关感染。国家卫生安全网沿着美国疾病控制中心进行监测，将医院感染部位分为13类50个感染部位，并根据生物学和临床标准进行具体分类。通常涉及医院获得性感染的病原体包括链球菌属，不动杆菌属，肠球菌、铜绿假单胞菌、凝固酶阴性葡萄球菌、金黄色葡萄球菌、蜡状芽孢杆菌、军团菌和肠杆菌科成员，即奇异变形杆菌、肺炎克雷伯菌、大肠杆菌、粘质沙雷氏菌。医院病原体可以通过人与人、环境或污染的水和食物、受感染的个体、受污染的医护人员的皮肤或通过共用物品和表面的接触传播。多重耐药的院内微生物主要包括耐甲氧西林金黄色葡萄球菌、耐万古霉素肠球菌、铜绿假单胞菌和肺炎克雷伯菌，而艰难梭菌显示天然耐药性。广谱抗生素的过度使用和不当使用，尤其是在医疗机构中，正在增加医院感染，这不仅成为一个大的医疗保健问题，而且给社区造成巨大的经济和生产损失。医院感染可以通过测量和比较医疗机构内的感染率并坚持最佳医疗实践来控制。疾病控制和预防中心提供了监测医院感染的方法，沿着对重大疫情的调查。通过这种监测，医院可以制定一项包括感染控制措施的战略。
Nosocomial infections are also known as hospital-acquired/associated infections. National Healthcare Safety Network along with Centers for Disease Control for surveillance has classified nosocomial infection sites into 13 types with 50 infection sites, which are specific on the basis of biological and clinical criteria. The agents that are usually involved in hospital-acquired infections include Streptococcus spp., Acinetobacter spp., enterococci, Pseudomonas aeruginosa, coagulase-negative staphylococci, Staphylococcus aureus, Bacillus cereus, Legionella and Enterobacteriaceae family members, namely, Proteus mirablis, Klebsiella pneumonia, Escherichia coli, Serratia marcescens. Nosocomial pathogens can be transmitted through person to person, environment or contaminated water and food, infected individuals, contaminated healthcare personnel's skin or contact via shared items and surfaces. Mainly, multi-drug-resistant nosocomial organisms include methicillin-resistant Staphylococcus aureus, vancomycin-resistant enterococci, Pseudomonas aeruginosa and Klebsiella pneumonia, whereas Clostridium difficile shows natural resistance. Excessive and improper use of broad-spectrum antibiotics, especially in healthcare settings, is elevating nosocomial infections, which not only becomes a big health care problem but also causes great economic and production loss in the community. Nosocomial infections can be controlled by measuring and comparing the infection rates within healthcare settings and sticking to the best healthcare practices. Centers for Disease Control and Prevention provides the methodology for surveillance of nosocomial infections along with investigation of major outbreaks. By means of this surveillance, hospitals can devise a strategy comprising of infection control practices.