Activity 9

Group Name:
Miley Virus / 2BSN-B

Group Members:
Balan, Althea Juomelle D.
Cuizon, Francheska Anne Christine B.
Guarino, Fiona Marie A.
Rosario, Adrian Chando P.
Sy, Julliene Francez D.
Ty, June Rayneil O.

COURSE TITLE: MICROBIOLOGY AND PARASITOLOGY

(LAB)

COURSE CODE: MIC 101a

COURSE DESCRIPTION: This course is designed to assist students in the study of

important microorganisms and parasites. It explains the physiology and pathogenic
properties of bacteria, fungi and viruses as an introduction to disease causation, their
biology, the infections they cause, host response to these infections and their mode of
transmission, prevention, treatment and nursing responsibilities. The laboratory
experiences provide specimen collection, handling and processing of specimens for
isolation and identification of microorganisms and parasites involved in the infectious
processes.

Hospital-Acquired Diseases: Nosocomial Infection

Hospital-acquired infections or nosocomial infections are caused by various

bacteria, viruses, or even fungi when a patient is undergoing medical care. Persons
exposed to the physical environment of a hospital like medical and support staff, and even
people visiting the hospital can also acquire nosocomial infections. Infections are even a
major problem in most healthcare settings today. Several studies revealed that they can
acquired by prolonged hospital stay or confinement that lasts approximately one or two
weeks. Manifestations may become clinically apparent either during the hospital stay or
after discharge.

Pathogens that can cause nosocomial infections often develop resistance to

standard antimicrobials making therapy and control more difficult and costly.
Understanding the epidemiology of nosocomial infections is very important for effective
control and prevention.

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Questions for Research:

1. Name three most common pathogens that cause nosocomial infections

and describe each.

Staphylococcus aureus – is a gram-positive bacteria that are the root cause

of numerous clinical disorders. It is a particular kind of germ that 30% of people
have in their nostrils. Staph often doesn't hurt anyone, although occasionally it
might result in infections. It is the main contributor to skin and soft tissue
infections such cellulitis, furuncles, and abscesses (boils).

Escherichia coli – are present in the intestines of both humans and animals,
as well as in the environment, food, and foods. Additionally, it is typically
discovered in warm-blooded creatures' lower intestines.

Enterococci – it is a short- and medium-chain gram-positive facultative

anaerobic cocci that can produce nosocomial infections that are challenging to
treat. They frequently result in UTIs, bacteremia, and infective endocarditis, but
infrequently meningitis and intra-abdominal infections.

2. List five of the most common nosocomial infections and describe each.

Urinary tract infections (CAUTIs)

Infections of the urinary tract, known as UTIs, are brought on by the growth
of microorganisms that are already present in the urinary tract. An infection can
harm the bladder as well as the kidneys if germs are allowed to penetrate the
urinary system, which typically occurs through the use of a catheter. UTIs
account for 14% of all HAIs and, like other device-associated infections, are
typically induced by direct exposure to a contaminated surface or by polluted
air.

Surgical site/wound infections

In addition to infections that are related to medical devices, HAIs can also
be contracted at surgical incisions as well as wounds. In light of this fact, 22 %
of hospital-acquired infections affect surgical incision sites. These sites may
involve the skin, underlying tissues, or even organs. Infections can also include
a material or equipment that has been surgically implanted. As the incision
heals, these infections might manifest themselves anywhere between a few
days to several months after surgery.

Ventilator-Associated Pneumonia (VAP)

The utilization of a ventilator is frequently linked to the development of
pneumonia as well as other respiratory or lung infections, which together
contribute to 22% of all HAIs. A ventilator is a machine that helps a patient
breathe by inserting tubes into the patient's body through the mouth, the nose,

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 or an incision made in the throat. It is possible for microorganisms to get into
the ventilator and then be transferred to the patient's lungs.

Primary bloodstream infections

Infections might be present in the bloodstream at times. This indicates the
presence of infectious microorganisms within the circulatory system. An
infection can be considered "primary" if it first appeared in the bloodstream, or
"secondary" if it spread to the bloodstream from another part of the body. To
the extent of 11% of all HAIs, primary bloodstream infections are strongly linked
(84%) to the insertion of a central line. A central line is a catheter placed in a
large vein to administer fluids, blood, or medication to the patient.

Gastrointestinal infections
All of the organs that help with digestion and waste removal make up the
gastrointestinal tract. There are billions of bacteria, particularly e. coli, that call
these tissues and organs home. Infection can take place if the usual balance
of these bacteria is altered (for instance, due to the administration of antibiotics)
or if a new bacterium is present. When the body has a gastrointestinal infection,
it attempts to remove itself from the pathogen by producing contaminated
waste, such as vomiting and diarrhea. There is a possibility of future
contamination from this waste if it isn't cleaned regularly and thoroughly. More
specifically, Clostridium difficile (C.diff) is widely accepted as the primary cause
of healthcare-associated infective diarrhea and therefore is increasingly
connected to community-acquired cases of colitis. The spores of C. diff, which
can be found in the intestines of humans and animals alike, are found
everywhere, can live on environmental surfaces for a long time, and are
particularly resistant to decontamination.

3. How can nosocomial infections and illnesses be prevented?

A subgroup of infectious diseases contracted in a healthcare setting is

known as nosocomial infections, often known as health-care associated or
hospital-acquired infections. The infection must appear at least 48 hours after
admission in order to qualify as nosocomial, not at admission. Implementing
infection control procedures in healthcare institutions to lower external and
endogenous transmission is the first step in the prevention of nosocomial
infections.

The most crucial prophylactic strategy to stop the spread of germs is routine
hand washing. Adherence with isolation protocols and using personal
protective equipment as directed are further safeguards. In addition, healthcare
professionals should refrain from using indwelling devices when it is not
necessary and remove them as soon as is appropriate. Finally, using adequate
aseptic and/or sterile practices while inserting and maintaining devices is
another way to reduce environmental transmission. For instance, constant

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 surface, patient, and medical equipment disinfection as well as proper waste
management are crucial steps in limiting the spread of nosocomial diseases.

4. Most nosocomial pathogens develop resistance to standard antibiotics.

What may be the reason for this?

The first factor that contributes to the rising incidence of hospital acquired
infections brought on by antibiotic resistant bacteria is the selection of resistant
mutant strains from the patient's own flora during antibiotic treatment. Resistant
strains then spread among hospital patients. Patient-related factors such as
immune suppression, the presence of foreign body infections that compromise
local host defenses, or the presence of a significant bacterial culture that serves
as a reservoir for resistant mutants all contribute to the selection of resistance
in infecting or colonizing bacteria.

Furthermore, the more a patient uses antibiotics, the more resistant it gets
in the body, since when someone uses antibiotics, susceptible bacteria are
killed, however it's possible that resistant bacteria are still able to spread and
thrive. Antibiotic misuse and overuse are the main factors contributing to the
rise in drug-resistant bacteria. Additionally, the more antibiotics we take, the
higher the chance that bacteria will develop resistance to them.

5. Aside from infected persons, enumerate and explain other possible

sources of nosocomial infections.

Aside from infected persons, other possible sources of nosocomial infections

include:

• Urinary Catheters
- Urinary catheters are inserted into the bladder in order to collect urine for
patients who are having difficulty or cannot control their bladder. A
nosocomial infection may occur if the pathogens move through the
perineum or the catheter inserted is contaminated, leading to urinary tract
infections.

• Surgical Procedures
- Surgical procedures are medical interventions that involve the need of
surgery, whether to replace, remove, or modify a certain organ, tissue, or
body part. A nosocomial infection may occur if the pathogens already in the
patient’s skin or those shed by the operating room staff during the procedure
enter the patient. Factors for these to happen include length of operation,
surgical technique, and operating room sterility.

• Central Venous Catheters

- Also known as a central line, a central venous catheter is a tube placed in
a large vein which can be found either in the neck, arm, chest, or groin that

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 can indefinitely remain in place. A nosocomial infection happens when
pathogens penetrate the skin during the insertion of the catheters, leading
to bloodstream infections.

• Mechanical Ventilation
- Mechanical ventilation is a type of therapy that allows you to breathe
whenever you can’t on your own with the assistance of a machine. A
nosocomial infection occurs when the oropharyngeal flora present prior to
the application of mechanical ventilation is breathed in by the patient during
the course of the therapy, leading to respiratory infections.

REFERENCES

https://www.who.int/news-room/fact-sheets/detail/e-coli

https://www.ncbi.nlm.nih.gov/books/NBK567759/

https://www.cdc.gov/ecoli/index.html

https://www.cdc.gov/hai/organisms/staph.html

https://www.ncbi.nlm.nih.gov/books/NBK441868/

https://blog.eoscu.com/blog/the-most-common-sites-and-types-of-hospital-acquired-infections

https://inivos.com/blog/5-most-common-hospital-acquired-infections-hais/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1113836/

https://www.rxlist.com/antibiotic_resistance/drugs-
condition.htm#:~:text=Antibiotic%20use%20promotes%20the%20development,increase%20in%
20drug%2Dresistant%20bacteria.

https://www.osmosis.org/answers/nosocomial-
infection#:~:text=Often%2C%20nosocomial%20infections%20are%20caused,infection%20contr
ol%20and%20prevention%20procedures.

https://my.clevelandclinic.org/health/treatments/15368-mechanical-ventilation

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