Hospital Infections

Infections in the hospital are mainly caused by viruses, bacteria, or other microorganisms. Hospital-acquired infections, also called nosocomial infections, are infections that patients get while undergoing surgical treatment at the hospital. According to CDC, 1 in every 31 patients can get hospital-associated infections. The estimated number of infection cases each year is 1.7 million and accounts for 99,000 deaths per year. The amount of human suffering and financial losses due to these infections can lead to an enormous burden on the healthcare system as well as on patients. 32% of hospital-acquired infections are urinary tract infections, 22% are surgical site infections, 15% are pneumonia (lung infection) and 14% are bloodstream infections.                           

Catheter-associated urinary tract infections   

Urinary tract infections are the most common type of hospital-acquired infection. Among urinary tract infections, 75% of the infections are associated with the use of a urinary catheter. The urinary catheter is a soft hollow tube passed into the bladder to drain urine when the patient cannot empty the bladder the natural way. There is a 15%-25% chance that you may receive a urinary catheterization during your stay in the hospital. This may potentially put you at a higher risk for infections, the most common of which being in the urinary bladder. If left unaddressed, the infection can then spread to other adjacent sites like the urethra, ureters, and kidneys, turning it into a more severe condition. Generally, most infections like these are resolved by prescribing the proper course of antibiotics.

The infections are common with any medical or surgical procedures, but the lack of quality care and ill-treatment you get from a doctor can be the basis of your malpractice case. It is your doctor’s responsibility to maintain hygiene, use aseptic and sterile instruments, and accurately monitor urine output.

Surgical site infections  

Surgical site infections occur at the site where the surgery was performed. Most surgical site infections are superficial, involving only skin. Some spread into the deeper parts of the skin, organs, or around implanted material. Surgical site infections can occur as a result of your body’s immune reaction to the procedure. At times, infections are preventable and the body's natural reaction does not develop an infection. However, infection develops in 1-3% of the patients who undergo a surgical procedure. A surgical wound infection may have pus draining, can be red, painful, and warm to touch.

Infections can be treated with antibiotics, but if left untreated, may develop into postoperative sepsis and spread throughout the body. 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 (e.g abdominal cavity) leads to complications after the surgical procedure, even if sterilization procedures and protocols are followed by the doctors. After the surgery, the bacteria could still multiply, triggering the body’s reaction and ultimately causing postoperative sepsis. It is still sporadic, occurring in less than 1% of patients. Complications associated with certain diseases like diabetes can also increase the risk for surgical site infection.

These are certain circumstances that may put patients at higher risk for surgical site infections. It goes without saying that the doctors must follow the infection control protocols and strategies to prevent infection. Moreover, while treating high-risk patients, doctors must take additional precautions and educate them before and after the surgery on how to prevent infections.

If you feel that a surgical procedure has gone wrong in the past as a result of a possible lack of pre and/or post-operative care, you may claim medical negligence on the part of the doctor/hospital that resulted in the surgical site infection.

Ventilator-associated pneumonia

Ventilator-associated pneumonia is a complication a patient may get if he or she was placed on a ventilator in the intensive care unit. Out of all intensive care unit (ICU) nosocomial pneumonia infections, 86% are ventilated-associated pneumonia. A ventilator is a machine that supplies breathable air in and out of the lungs through a tube. Pathogens can enter through this tube and get into the lungs causing a lung infection. This often occurs at least 48 hours after hospital admission.

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 it is necessary that the doctor chooses the appropriate antimicrobial drug treatment to avoid later complications.

Bloodstream infections

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 into the circulation via the bloodstream, it leads to a serious 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 flow of the blood to the organs and can cause organ failure. In many other cases, there is no organ failure 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 to occur 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.

The various reasons that lead to central line bloodstream infection are:

  • Contamination on insertion site of the blood catheter

  • The bacteria present on the patient’s skin

  • The breach in the 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

 

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. If there is a deviation from any of these standards of care and you or your loved ones have suffered serious infections or an unfortunate incident like death, then you should speak to a qualified medical malpractice attorney.