At present, healthcare-associated (nosocomial) infections are considered a global public health problem, with an increasing incidence in healthcare institutions. Their appearance is responsible for an increase in patient mortality, the consumption of healthcare resources and a decrease in both, the safety and quality of the service provided.

This occurs when patients acquire infections while receiving medical care, whether during surgery, in an intensive care unit or even in a simple consultation. Nosocomial infections occur throughout the world and affect developed and developing or underdeveloped countries, the latter being the most affected, as they do not have sufficient tools to prevent them.

What are the main factors that can cause a hospital infection?

• Imbalance of the bacterial skin and body flora, generally due to excessive or inappropriate use of antibiotics.
• Decreased immune system of the hospitalized person, both due to the disease and the use of medications.
• Performing invasive procedures such as catheter placement, probes, biopsies, endoscopies or surgeries, which break the skin's protective barrier.
• Cross transmission: Lack of adequate hygiene, such as hand washing and cleaning equipment, which contributes to the spread of resistant microorganisms.

And the most resistant microorganisms are:

Gram-positive bacteria:

• Methicillin-resistant Staphylococcus aureus (MRSA): One of the best-known bacteria for its resistance to multiple antibiotics, including methicillin.
• Vancomycin-resistant Enterococcus (VRE): These microorganisms can cause serious infections, especially in patients with weakened immune systems.
• Clostridium difficile: Although not resistant in the classic sense, this bacteria can cause severe infections after antibiotic treatments that alter the normal intestinal flora.

Gram-negative bacteria:

• Escherichia coli and Klebsiella pneumoniae: These bacteria can be resistant to carbapenems (CRE), a class of last-resort antibiotics.
• Pseudomonas aeruginosa and Acinetobacter baumannii: Known for their ability to resist multiple antibiotics and cause infections in hospitalized patients.

Other microorganisms:

Resistant fungi, such as Candida auris: This emerging fungus is resistant to multiple antifungals and has caused outbreaks in hospitals around the world.

With proper hygiene measures and infection control protocols, it is possible to significantly reduce the risk.

So what can we do about it?

• The practice of proper and frequent handwashing
• The use of Personal Protective Equipment (PPE) for healthcare professionals
• Promoting vaccination among staff and patients
• Disinfection and sterilization of medical instruments and equipment

In this last measure, UV light disinfection is positioned as a reliable method to ensure microbiological safety. It occurs by deactivating pathogens by interacting with nucleic acids, altering their genetic structure and preventing their replication.

Bacteriophage therapies are an innovative approach in the fight against bacterial infections. They are based on the use of bacteriophages or "phages", viruses that specifically infect and destroy pathogenic bacteria without damaging human cells. This method offers a promising alternative to the increasing number of hospital-acquired infections.

Specific management strategies in ICUs (intensive care units)

Some intensive care units are adopting innovative strategies to reduce the risk of infections, such as:

• Using antimicrobial coatings on frequently touched surfaces
• Installing curtains with antimicrobial properties to separate patients
• Implementing specific areas for patients with highly transmissible infections
• Using negative pressure systems in rooms to prevent the airborne spread of microorganisms
• Electronic systems that alert about non-compliance with hand hygiene or standardized procedures
• Real-time data analysis to identify infection patterns before they become outbreaks.

The management of nosocomial infections represents one of the greatest challenges in modern healthcare. Through the strategies mentioned above, healthcare institutions are making progress in protecting the most vulnerable patients.

Their implementation, together with ongoing staff training and constant effectiveness evaluation, underlines the healthcare system's commitment to adapt to a constantly evolving situation.