Third Degree Burns and Hospital Acquired Infections (Part II)

Origin of hospital acquired infection:

Hospital acquired infection can be external (from outside the body) or internal (from the inside of the body).

External (Exogenous) infection: examples of external sources of infection may include

1. Catheters such as the urine catheter (Foley Catheter)
2. Instruments such as speculum, scissor, forceps.
3. Hands if they are not properly sterilized.
4. Blood product transfusion which can transmit Hepatitis B and HIV.
5. IV lines like Central and Picc lines.
6. Respiratory equipment such as ventilators.
7. Airborne infection: such as Tuberculosis (TB).
8. Linen that are contaminated.

Internal (Endogenous) infections: Internal sources of infection may include

1. Skin: Certain bacteria live on the skin of many healthy individuals without causing any infection. However, these bacteria can cause skin infections if they enter the body through a break in the skin as in burns, open wounds and cuts. Staphylococcus aureus (Staph) is a bacteria that can be found living on the skin and in the nose of many healthy people without causing any infections. This bacteria can cause skin infections such as boils when the circumstances are appropriate.
2. Oropharynx.
3. Respiratory System.
4. Gastrointestinal tract.

• Pathogens that cause hospital acquired infections can be Bacteria, Fungi, Viruses and Protozoa.
• Pathogens vary in their virulence (the ability of a microorganism to cause disease); the more virulent the organism is, the less the number needed to produce the disease.
• The sicker the patient is, the higher the risk of contracting a hospital acquired infection.
• The lower the patient’s immunity is, the higher the risk of getting a hospital acquired infection.
• Certain circumstances may favor the growth and survival of the microorganism such as wet versus dry objects. Contamination is heavier in wet objects than dry objects.

Certain factors may affect the susceptibility of the patient to get nosocomial:

1. The age of the patient: elderly and infants are more susceptible for infection.
2. The presence of pre-existing diseases (co-morbidity): chronic diseases such as chronic kidney disease, chronic liver disease and diabetes can increase the patient’s risk for contracting a hospital acquired infection as all these diseases may interfere with the immunity of the patient making him/her more susceptible for infection.
3. Low or compromised immune system: any condition that suppresses the immune system can increase the susceptibility of the patient for an infection.
4. Malignancy, chemotherapy and radiotherapy: as all may suppress the immune system.
5. Treatment with Antibiotics: this can cause the growth of antibiotic resistant micro-organisms that can cause hospital acquired infection.
6. Procedures and surgeries: therapeutic and/or diagnostic procedures and surgeries may increase the susceptibility of the patient for a hospital acquired infection.

Measures taken by the healthcare staff to prevent and/or control nosocomial infection:

• Proper hand washing and/or cleansing.
• Wearing gloves, masks and gowns.
• Aseptic technique and procedure practice.
• Isolating patients with communicable diseases.
• Proper disinfection and sterilization of reusable equipment.
• Immunization patients at risk.
• Proper disposal of waste product.
• Prophylaxis
• Educating patients and public about the causes, methods of transmission, treatment and prevention of infection

This information is not intended nor implied to be a substitute for professional medical advice; it should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. Call 911 for all medical emergencies.