Nosocomial infections refers to infections acquired during hospitalization, with symptoms usually occurring within forty-eight hours after admission.
The origin of nosocomial infections can be attributed to the following:
- Bacterial flora already present in the patient;
- Microorganisms from the environment through transmission from: carriers colonized at admission, admitted to wards without undergoing surveillance, isolation or eradication of the germ(s); patients who have developed the infection but who have not been isolated;contact with contaminated objects and surfaces; medical personnel, usually via their hands; invasive procedures such as the installation or maintenance of a ...view middle of the document...
The increase in infection-related health activity is the result of a gradual increase in specific risk factors such as antibiotic pressure and the greater complexity of patients’ conditions. Despite their strong impact, both socially and economically, the surveillance systems and programs currently deployed for the prevention of nosocomial infections are quite dishomogeneous and, in many situations, do not exist at all.
There are two main discriminating factors in this critical situation. The first relates to the chronic lack of funds for a serious policy of prevention, particularly in terms of an effective screening process. The second concerns the lack of accurate knowledge and widespread awareness on the part of health-care operators who are apparently unable to see the problem, in its complexity, as a factor that impacts on all health-care processes, be that at regional or hospital level.
Another crucial element to consider is the emergence of bacterial strains resistant to antibiotics,given the widespread use of these drugs as a prophylactic or a therapeutic regimen.
How MRSA relates to the disease symptoms
Non-specific resistance, to an invading organism, or pathogen, is a defence mechanism the body employs to protect itself from attack (Tortora and Grabowski 1996). Inflammation, response to bacterial invasion, occurs due to release of chemicals in the bloodstream causing vasodilation and increased capillary permeability increasing blood flow and cellular activity to the affected area and surrounding tissues (Waugh and Grant 2001). The result of this increased activity causes redness, swelling and heat. A process called chemotaxis, chemical attraction, draws necessary cells to the damaged area, travelling through gaps in the capillary wall in a process known as diapedesis (Van De Graff and Fox 1995). Phagocytosis occurs at this point by engulfing the invading micro-organism at the site of infection. As the phagocytes die and dead cells increase a pocket of exudate is formed which can rupture onto the surface in the form of pus. Due to recent surgery Mrs C may not experience increased pain although this is an important symptom of inflammation, which is created by pressure from the swelling.
Fever occurs when the temperature setting in the thermostat of the hypothalamus is displaced upwards due to the discharge of pyrogens, released during phagocytosis. The thermoregularoty reflex then initiates the mechanism to raise core temperature and results in pyrexia (Tortora and Grabowski 1996).
ii) Predisposing factors that make the host susceptible to MRSA
The S aureus organism can be found naturally on 50% of the population maintains Alexander et al (2000). MRSA colonises on areas of the skin, but only becomes infectious when immunity is compromised and integrity is lost. Nursing Times (2003a) states MRSA is unlikely to develop into an infection in a healthy individual. However according to Hosein et al...