Iatrogenic Infection In Icu

Iatrogenic infections in ICU Introduction Iatrogenic or nosocomial transmittal is defined by any infection acquired during or as a result of infirmaryization . They may affect the patient , infirmary staff . Majority of the nosocomial infections become clinic altogethery appargonnt while the patient is however in the hospital however the onset of the disease back occur even after the patent the patient is dismissed . The infections that stir longer incubation periods those were evidenced to have con parcel of land during the hospital rub argon too classified as nosocomial infections . Thus hepatitis B virus infection may be acquired in the hospital but overdue to its draw out incubation period may not become clinically app bent until months after the patient is discharged from the hospital . On the other side the infections that carry an evidence to incubate forrader the time of admission to the hospital and seting in the hospital atomic number 18 not classified nosocomial and argon community acquired endogenous infections ar ca procedured by patients own flora or unremarkably inhabiting micro-organisms in the oral cavity , skin or GI tract . Exogenous infections are ca workd by a denotation other than the patient itself . The infection results from interactions between an infectious federal agent and the susceptible host . This occurs by means of direct signature , viridity vehicle spread viz . air borne and vector borne etc . theoretically the induced infectious spread by all modes of contagion that are known to occur in the communityIncidence In the States the National Nosocomial Infection Surveillance (NNIS ) is keeping surmount of the nosocomial infections since 1970 . harmonise to the recent reports the preponderance of nosocomial infections is app . 6 . Iatrogenic infections preponderance in ICU setting is 5 - 10 time to a greater extent than general wards due to play use of urinary catheters , invasive techniques and use of endotracheal tubes and ventilators Urinary tract infections are closely common (28 ) followed by surgical appall infections (19 , Pneumonia (17 ) and intra venous twisting relate blood infections . Skin and easy tissue infections are less commonIdentify attempts Iatrogenic infections need saloon because of potential deliterious effects by increasing morbidity , mortality and worsening the disease severity there by cause increased duration of hospital stay , extra hospital costs . Patients susceptible to the super added infections to nosocomial infections are all immuno-compromised hosts and patients receiving immuno-suppressants , patients at the extremes of ages , neutropenia , malnutrition , diabetes mellitus , patients with history of organ transplant and with under deceitfulness continuing illness like COPD . closely of the infections (90 ) are of bacterial etiology however viral , fungous and protozoan microorganisms have also been frequently found . Urinary tract infections are the approximately prevalent of the nosocomial infections . The other underlying organic fertiliser causes are contaminated surgical wounds , pneumonia (17 ) and ventilator associated pneumonitis . However excessively all these underlying factors there are cirtain factors those are due to the need of skill or negligence by the nurse staff and health personell . These must be very all the way elaborated before we can proceed further to the strategic planning for the prevention and control of iatrogenic infections in intensive care units . It principly involve the breech of the aseptic precautions taken by the hospital staff while the patient is in the hospital . For example , the patients who have indwelling urinary catheters or those who underwent approximately urological instrumentation may be particularly susceptible to UTI because of the deprivation of aseptic introduction of the catheter and monitoring of close sterile waste pipe sytem and breech of appropriate catheter care . Cross infection of the surgical wounds is favoured by the lack of simple techniques of hand washing and lack of the use of prophylactic antibiotics . Proper inspectionof the superficial wounds for the signs of infections like honoring for erythema , pain swelling or pus discharge at the site of wound need a proper acquaintance and traing in medicine . Amongst the patients in critical care units those are intubated and on mechanic ventilators , Ventilator associated Pneumonitis is dreaded complication that is predisposed by breech of aseptic suction techniques , aspiration and unbecoming way of suctioning and physiotherapy ca victimisation impaired ability to crown the chest secretions . Improper disinfection and care of respiratory equipments , humidifiers , endotracheal tubes and the dialysis system is also due to defaulter health system at the face level . In a nutt shell the inability to employ cirtain simple aseptic techniques like hand washing , use of sterile gloves , and disinfection of the catheter or canula insertion site and the use of erect sterile drapes to cover the patientsSCOPE OF THE RISK AND BRIEF INTRDUCTION TO THE TYPES OF ICU INFECTIONS According to the recent reports the prevalence of nosocomial infections is app . 6 . Iatrogenic infections prevalence in ICU setting is 5 - 10 times more than general wards due to routine use of urinary catheters , invasive techniques and use of endotracheal tubes and ventilators . Urinary tract infections are most common (28 ) followed by surgical wound infections (19 , Pneumonia (17 ) and intra venous thingmajig related blood infections . Skin and soft tissue infections are less common Host factors : Host factors which predispose a patient to nosocomial infections are the following (1 )All immuno-compromised hosts and patients receiving immuno-suppressants are particularly vulnerable though the iatrogenic infections are rather common in immuno-competent patients (2 )Extremes of ages (3 )Neutropenia (4 )Malnutrition (5 )Diabetes mellitus (6 )Patients with history of organ transplant (7 ) to a lower place lying inveterate illness like COPD Agent factors (microbiology : Most of the infections (90 ) are of bacterial etiology however viral , fungal and protozoan microorganisms have also been frequently found . lately in patients with organ transplantation , aggressive surgical procedures , patients receiving anti-neoplastic drugs and human immunodeficiency virus infected individuals are particularly show increased prevalence of infections with fungi (Candida Types of the nosocomial infections and the risk assessment Urinary nerve tract Infections : Urinary tract infections are the most prevalent of the nosocomial infections . Nearly all patients who have indwelling urinary catheters or those who underwent some urological instrumentation are particularly susceptible peculiar(prenominal) host factors associated with UTI are (1 )female sex (2 )prolonged urinary catheterization (3 )breech of appropriate catheter care (4 )severe underlying chronic illness E . coli and genus Pseudomonas are the most common bacteria associated with UTI .

Candida is also an important abortifacient agent for iatrogenic UTI in intensive care setting Surgical injury Infections : Surgical wounds are classified as clear , clean contaminated and contaminated wounds . Clean wounds are those wounds in which gastrointestinal , genitourinary and respiratory tracts are not entered or inscribed during the course of the surgery , e .g . Hernioplasty . In cases of clean contaminated surgeries incision of gastrointestinal , genitourinary and respiratory tracts is done , e .g . Appendicectomy . Contaminated wounds are the wounds in which there is plebeian spillage of gastrointestinal contents resulting into acute inflammatory response . The risk of infections increases from clean through contaminated wounds . The other risk factors include (1 )Length of the surgery (2 )Prolonged period of hospital say (3 )Presence of remote infection (4 )Underlying chronic disease (5 )Presence of prophylactic drains Clinically the wound infections present with erythema , pain swelling or pus discharge at the site of wound Pneumonia : pneumonia includes 17 of all the iatrogenic infections and its relative incidence is very high amongst the patients in critical care units and 9 - 25 in patients on mechanical ventilators . Crude mortality amongst these patients rates 30 - 44 . Early onset of nosocomial pneumonia occurs during the first four days of hospital stay and the causative organism is predominantly pneumococci , H . infuenzae and anaerobes . Late onset of nosocomial pneumonia after first four days of hospital stay and the causative organism are gram negative bacilli (Klebsiella , Acinetobactor and Pseudomonas ) and Staphylococcus aureus . The triad of endotracheal intubation , altered mental berth and nasogastric tube is associated with high incidence of iatrogenic pneumonia . The other complete risk factors are mentioned below Patient related (1 ) innovative age (2 )smoking (3 )malnutrition (4 )prolonged hospitalization (5 )coma (6 )co morbid illness Infection related (1 )prolonged use of antibiotics and sedatives (2 )H2 - receptor blockers (3 )immunosuppressant (4 )endotracheal intubation (5 )nasogastric tube (6 )thoraco-abdominal surgery diagnosing of nosocomial pneumonia is suspected in cases with new or modern chest radiographic infiltrates after 48 hours of infection associated with pyrexia , leucocytosis and purulent respiratory secretions . The other causes of pneumonic infiltrates are pulmonary hemorrhage , congestive cardiac failure and atelectesis . The diagnosis is back up by culture trial runs of sputum or the endotracheal secretions and also the examination for gram staining however the fibro-optic bronchoscopy and BAL fluid examination yields more specific results Ventilator associated Pneumonitis : This dreaded complication is the second most common iatrogenic infection in the ICU related infections with an attributable mortality of approximately 30 . The predisposing factors for ventilator associated pneumonitis are the following : - (1 )severity of illness (2 )duration of intubation and mechanical ventilation (3 ) breech of aseptic suction techniques (4 )aspiration (5 )chronic lung disease (6 )advanced age (7 )malnutrition (8 )immuno suppressor drug therapy (9 ) blue level of consciousness (10 )impaired ability to clear secretions Intravascular device related infections : The most important clinical outcome using intravascular device related infection is increased mortality (50 Infection rates related with related with I /V catheters is summarized as followed ...If you want to get a full essay, order it on our website: Ordercustompaper.com

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