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[Nosocomial infections--a consequence of modern therapeutic and diagnostic methods (author's transl)]
Abstract:
Nosocomial infections are an increasingly observed complication of modern therapeutic and diagnostic procedures. They may arise exogenously, i.e. during nursing or medical care (contaminated instruments, catheters, inhalers, infusions) or endogenously by the patient's own bacterial flora. Characteristic of exogenous nosocomial infections are enterobacteriaceae and Pseudomonas strains; they are of low virulence, are generally highly resistant to antibiotics and able to survive for long periods even in an unfavourable environment. Endogenous infections are most easily induced during operations on parts of the body that normally show a dense bacterial population such as the intestine; but they are also a dreaded complication of foreign body implants. Endogenous infections after non-sterile operations are most frequently due to enterobacteriaceae and bacteroides, especially Bacteroides fragilis. Endoprostheses are mainly infected by micro-organisms present on the skin, such as staphylococci, streptococci and corynebacterium. An important cause of nosocomial infections is a disturbance of the balance of the normal bacterial flora by uncritical and haphazard use of antibiotics.
Insights
Nosocomial infections, or hospital-acquired infections, stem from external sources or a patient's own bacteria. Antibiotic overuse disrupts natural flora, increasing infection risk.
Area of Science:
- Infectious Diseases
- Microbiology
- Hospital Epidemiology
Context:
- Nosocomial infections are a significant challenge in healthcare settings.
- They arise from exogenous contamination (e.g., medical devices) or endogenous sources (patient's flora).
- Modern therapeutic and diagnostic procedures increase the risk of these infections.
Purpose:
- To elucidate the origins and characteristics of nosocomial infections.
- To identify common pathogens associated with exogenous and endogenous infections.
- To highlight the role of antibiotic misuse in disrupting microbial balance.
Summary:
- Exogenous infections often involve Enterobacteriaceae and Pseudomonas strains, characterized by low virulence, high antibiotic resistance, and environmental persistence.
- Endogenous infections are linked to surgical procedures, particularly involving the gastrointestinal tract or foreign body implants.
- Common pathogens include Enterobacteriaceae, Bacteroides (especially B. fragilis), Staphylococci, Streptococci, and Corynebacterium.
Impact:
- Understanding infection sources is crucial for developing effective prevention strategies.
- Recognizing antibiotic-resistant strains aids in targeted treatment and infection control.
- Addressing antibiotic stewardship is vital to maintaining the integrity of the normal bacterial flora and preventing infections.
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