Healthcare-associated Infection (HAI)

Background

HAI, also known as nosocomial infection, which is the infection acquired by the patient during the process of care in a hospital or other health care facility. HAI also include occupational infections among staff. Based on WHO data, it is estimated that there is hundreds of millions of patients affected by HAI each year. About 7 – 10 out of 100 hospitalized patients will acquire at least one HAI. This has led to increase of fatality rate and financial losses for health systems.

Types of HAI

Types of HAI	Description
Central Line-associated Bloodstream Infection	It is a serious infection that occurs when germs enter the bloodstream through the central line. Central line is a catheter that place in a large vein in the neck, chest or groin to inject medication or to collect blood for medical check-up.
Catheter-associated Urinary Tract Infections	It is an infection associated with a urinary catheter, which affects urinary system, including urethra, bladder, ureters, and kidney.
Surgical Site Infection	It is an infection that occurs at the site where surgery took place.
Ventilator-associated Pneumonia	It is a lung infection that develops in a person who is on a ventilator. It occurs when germs enter the tube of ventilator and get into the patient’s lung.

Microorganism causing HAI

Table below summarize the common microorganism that causes HAI

Microorganism	Type	Disease / Symptoms
Acinetobacter	Gram-negative bacteria	Cause infections in the blood, urinary tract, and lungs (pneumonia), or in wounds in other parts of the body
Burkholderia cepacia	Gram-negative bacteria	May cause serious respiratory infections, especially in patients with cystic fibrosis
Clostridium difficile	Spore-forming bacteria	Diarrhea, fever, stomach tenderness, loss of appetite and nausea
Clostridium sordelli	Spore-forming bacteria	May cause pneumonia, endocarditis, arthritis, peritonitis, and myonecrosis
Carbapenem-resistant Enterobacteriaceae (CRE)	Gram-negative bacteria	May cause infection in almost any part of body, including bloodstream, urinary tract and pneumonia.
ESBL-producing Enterobacteriaceae	Gram-negative bacteria	May cause infection in almost any part of body, including bloodstream, urinary tract and pneumonia.
Hepatitis A, B, C	A: Enveloped virus B, C: Non-enveloped virus	May cause liver diseases.
Human Immunodeficiency Virus (HIV)	Enveloped virus	Cause acquired immune deficiency syndrome (AIDS).
Klebsiella	Gram-negative bacteria	May cause pneumonia, bloodstream infections, wound or surgical site infections, and meningitis
Staphylococcus aureus, including antibiotic resistant strains (MRSA, VRSA)	Gram-positive bacteria	May cause skin infections, sepsis, pneumonia, endocarditis and osteomyelitis
Mycobacteria	Mycobacteria	May cause infections in wide variety of body parts, especially the lungs.
Norovirus	Non-enveloped virus	Cause gastroenteritis
Pseudomonas aeruginosa	Gram-negative bacteria	Can cause infections at the site of surgery
Vancomycin-resistant Enterococci (VRE)	Gram-positive bacteria	May cause urinary tract infections, bloodstream infections and wound infections