What is a nosocomial (hospital-acquired) infection?

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Last updated: March 31, 2025View editorial policy

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From the Guidelines

A nosocomial infection is defined as an infection acquired in a healthcare facility, not present or incubating at the time of admission, with an incubation period generally considered to last for 48 h. According to the European recommendations for antimicrobial resistance surveillance 1, nosocomial infections are typically considered when the interval between admission to the hospital and onset of infection is >48 h.

Key Characteristics of Nosocomial Infections

  • Infections not present or incubating at the time of admission
  • Acquired in a healthcare facility
  • Incubation period generally considered to last for 48 h
  • Community-acquired infections are defined as infections not acquired in a healthcare institution, as distinguished from nosocomial infections 1

Prevention and Control

Prevention strategies for nosocomial infections include proper hand hygiene by healthcare workers, appropriate use of personal protective equipment, careful insertion and maintenance of medical devices, judicious use of antibiotics to prevent resistance, and thorough environmental cleaning and disinfection protocols.

Clinical Significance

Nosocomial infections can complicate patient recovery, extend hospital stays, increase healthcare costs, and can be life-threatening, emphasizing the importance of their prevention and control in healthcare settings.

From the Research

Definition of Nosocomial Infections

  • Nosocomial infections are a major source of revenue loss, morbidity, and even mortality to surgical patients 2.
  • They are serious medical complications that can be prevented by strict adherence to barrier precautions, protecting patients from hospital-acquired bacterial flora 2.

Causes and Risk Factors

  • The frequency of nosocomial infections lies between 5 and 10%, varying according to the type of hospital and service 3.
  • Age, underlying disease, invasive devices (such as catheters), or procedures are the main risk factors for nosocomial infections 3.
  • The use of indwelling urinary catheters is a primary cause of nosocomial urinary tract infections 4.

Types of Nosocomial Infections

  • Common nosocomial infections include:
    • Urinary tract infections 3, 5, 4
    • Pneumonias 2, 3
    • Surgical site infections 3
    • Bacteremia/septicemia 3
    • Intravascular catheter-related infections 3

Prevention and Treatment

  • Prevention is based on a better control of infection risk related to the use of invasive devices 3.
  • Discontinuation of catheter usage within 2 days, whenever possible, is the cornerstone to avoiding nosocomial urinary tract infections 4.
  • Patients with symptomatic infections should receive effective antimicrobial therapy, and removal of the catheter is also fundamental to clearing the urinary tract of infection 4.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Nosocomial infections and nosocomial pneumonia.

American journal of surgery, 1996

Research

[Epidemiology of nosocomial infections].

La Revue du praticien, 1998

Research

Nosocomial urinary tract infection.

The Surgical clinics of North America, 2009

Research

Urinary tract infections in the surgical patient.

The American surgeon, 1988

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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