Fujita K
Department of Pediatrics, Asahikawa Medical College, Japan.
Hokkaido Igaku Zasshi. 1994 Mar;69(2):161-5.
Hospital (nosocomial) infection means infection acquired by patients while they are in hospital, or by members of hospital staff. It will occur in modes of three categories; 1) cross-infection (infection acquired in hospital from other people, either patients or staff), 2) self-infection (infection caused by microbes which the patient carries on normal or infected areas of his own body) and 3) self-infection after acquisition of hospital pathogens from other people or the environment. Examples of hospital infections, that we experienced, were presented as follows; cross-infection due to gram-negative organisms as Pseudomonas aeruginosa and Acinetobacter in neonatal intensive care unit, cross-infection due to viruses as RS in infants with cardiovascular diseases and varicella in immunocompromised patients, and self-infection supervening cross-infection due to potential pathogens including MRSA in immunocompromised children as patients with malignant blood diseases and surgeries. The most important preventive measure for cross-infection would be isolation of the infected or colonized patients and hand-washing. To prevent self-infection, it is essential to maintain the defensive ability of patient including normal flora, and active immunization or prophylactic antibiotic treatment will be needed in some patients. Administration of antibiotics often permits selection and overgrowth of multiply resistant microorganisms and results in serious infections. Therefore, antibiotic policy would be mandatory in each hospital.
医院(医院内)感染是指患者在住院期间或医院工作人员所获得的感染。它会以三种类型发生:1)交叉感染(在医院内从其他人,即患者或工作人员那里获得的感染),2)自身感染(由患者自身身体正常或感染部位携带的微生物引起的感染)以及3)从其他人或环境中获得医院病原体后的自身感染。我们所经历的医院感染实例如下:新生儿重症监护病房中由铜绿假单胞菌和不动杆菌等革兰氏阴性菌引起的交叉感染,患有心血管疾病的婴儿中由呼吸道合胞病毒引起的交叉感染以及免疫功能低下患者中的水痘感染,还有免疫功能低下儿童(如患有恶性血液病和接受手术的患者)中由包括耐甲氧西林金黄色葡萄球菌在内的潜在病原体导致的在交叉感染基础上叠加的自身感染。交叉感染最重要的预防措施是隔离感染或定植患者以及洗手。为预防自身感染,维持患者包括正常菌群在内的防御能力至关重要,并且在某些患者中可能需要进行主动免疫或预防性抗生素治疗。抗生素的使用常常会促使多重耐药微生物的选择和过度生长,并导致严重感染。因此,每家医院都必须制定抗生素使用策略。