1. NOSOCOMIAL INFECTIONS

2. A hospital-acquired infection, also known as a HAI or in medical literature as a nosocomial infection, is an infection that develops in a patient during hospitalization. It is usually defined as an infection that is identified at least forty-eight to seventy-two hours following admission, so infections incubating, but not clinically apparent, at admission are excluded. With recent changes in health care delivery, the concept of “nosocomial infections” has sometimes been expanded to include other “health care–associated infections.”

3. The most frequent types of infection are urinary-tract infection, surgical-wound infection, pneumonia, and bloodstream infection. These infections follow interventions necessary for patient care, but which impair normal defenses.  Nosocomial pneumonia occurs most frequently in intensive-care-unit patients with endotracheal intubation on mechanical ventilation—the endotracheal tube bypasses normal defenses of the upper airway. Finally, primary nosocomial bloodstream infection occurs virtually only with the use of indwelling central vascular catheters, and correlates directly with the duration of catheterization.

4. In the United States, the Centers for Disease Control and Prevention estimated roughly 1.7 million hospital-associated infections, from all types of microorganisms, including bacteria, combined, cause or contribute to 99,000 deaths each year. In Europe, where hospital surveys have been conducted, the category of Gram-negative infections are estimated to account for two-thirds of the 25,000 deaths each year. Nosocomial infections can cause severe pneumonia and infections of the urinary tract, bloodstream and other parts of the body. Many types are difficult to attack with antibiotics, and antibiotic resistance is spreading to Gram-negative bacteria that can infect people outside the hospital.

5. Known nosocomial infections
Ventilator-associated pneumonia
Staphylococcus aureus
Methicillin resistant Staphylococcus aureus
Candida albicans
Pseudomonas aeruginosa
Acinetobacter baumannii
Stenotrophomonas maltophilia
Clostridium difficile
Tuberculosis
Urinary tract infection
Hospital-acquired pneumonia
Gastroenteritis
Vancomycin-resistant Enterococcus
Legionnaires' disease

6. Spreading of MRSA

7. Patient with sepsis (bed-sore)

8. Patient with sepsis (sugulations)

9. Furuncul

10. Carbuncul

11. Mastitis

12. Control and prevention
Prevention of nosocomial infections requires a systematic, multidisciplinary approach. This is usually achieved under the leadership of an institutional infection-control program. The principle activities of such a program include surveillance, outbreak management, policy development, expert advice, and education. An optimal program may decrease the incidence of nosocomial infections by 30 to 50 percent.

13. An effective infection-control program requires dedicated staff with appropriate training and sufficient resources. The number of personnel is determined by the size and complexity of the facility. Infection-control practitioners, usually from a nursing background, are responsible for program activity. In larger hospitals, program leadership is provided by a physician with training in epidemiology and infection control. Smaller facilities may obtain such expertise by contractual arrangement with outside experts. Oversight of the infection-control program is usually provided by a multidisciplinary infection-control committee. The program director, however, should report directly to senior hospital management to ensure optimal program effectiveness.

14. Sterilization
Sterilization goes further than just sanitizing. It kills all microorganisms on equipment and surfaces through exposure to chemicals, ionizing radiation, dry heat, or steam under pressure.

15. Isolation
Isolation precautions are designed to prevent transmission of microorganisms by common routes in hospitals. Because agent and host factors are more difficult to control, interruption of transfer of microorganisms is directed primarily at transmission.

16. Handwashing and gloving
Handwashing frequently is called the single most important measure to reduce the risks of transmitting skin microorganisms from one person to another or from one site to another on the same patient. Washing hands as promptly and thoroughly as possible between patient contacts and after contact with blood, body fluids, secretions, excretions, and equipment or articles contaminated by them is an important component of infection control and isolation precautions. 

17. The microbes comprising the resident flora
Staphylococcus epidermidis, S. hominis, and Microccocus, Propionibacterium, Corynebacterium, Dermobacterium, and Pitosporum spp., while in the transitional could be found S. aureus, and Klebsiella pneumoniae, and Acinetobacter, Enterobacter and Candida spp. 

18. Surface sanitation
Sanitizing surfaces is an often overlooked, yet crucial, component of breaking the cycle of infection in health care environments. Modern sanitizing methods such as NAV-CO2 have been effective against gastroenteritis, MRSA, and influenza agents. Use of hydrogen peroxidevapor has been clinically proven to reduce infection rates and risk of acquisition. 

19. Antimicrobial surfaces
Touch surfaces commonly found in hospital rooms, such as bed rails, call buttons, touch plates, chairs, door handles, light switches, grab rails, intravenous poles, dispensers (alcohol gel, paper towel, soap), dressing trolleys, and counter and table tops are known to be contaminated with Staphylococcus, MRSA (one of the most virulent strains of antibiotic-resistant bacteria) and vancomycin-resistant Enterococcus (VRE).