1. Of or relating to a hospital.
2. Of or being a secondary disorder associated with being treated in a hospital but unrelated to the patient's primary condition
The term "nosocomial" comes from two Greek words: nosus meaning "disease" and komeion meaning "to take care of." Broadly, "nosocomial" first applied to any disease contracted by a patient while under medical care. However, today it has become synonymous with "hospital-acquired". In other words, an infection a person acquired at a hospital and not one they had before they arrived.
The first autopsy I attended was that of a 22-year old pregnant mother. She was admitted to the hospital in perfect health. Her delivery was slow and so the doctor elected to perform a forceps delivery, resulting in tearing. On autopsy, it was determined she contracted a hospital-borne staph infection that precipitated her death three days later, a victim of a nosocomial infection - another iatrogenic death statistic.
Because these infections are usually resistant to commonly used antibiotics, they are sometimes dubbed "superbugs". Patients who catch superbugs can double their hospital stay, first recovering from the illness that brought them to hospital and then recovering from the infection.
Hospital-acquired infections include:
C. difficile - MRSA (a staph infection)
C. difficile bacteria grow in the large bowel. They thrive in the stool compressed inside the colon. The bacteria produce two toxins that cause diarrhea and damage the cells lining the bowel. It has caused almost four times the usual number of cases of severe diarrhea in hospitals, and can persist in the body for months despite repeated antibiotic treatments. Doctors know C. difficile flourish after patients take certain antibiotics. Now it seems any antibiotic can bring on the disease. How do I get it? The bacteria are almost exclusively picked up in hospital. Infections tend to arise when a hospitalized patient, who has been unwittingly colonized by the bug, is given antibiotics for another condition. Your risk of contracting the bacteria rises if you're undergoing chemotherapy, have abdominal surgery or have other stomach or intestine problems.
Necrotizing fasciitis (a strep infection)
Necrotizing fasciitis, or flesh-eating disease, is a fast-spreading infection caused by streptococcus bacteria that have been infected with a virus. Streptococcus bacteria cause infections such as strep throat and scarlet fever, but a more aggressive form is responsible for flesh-eating disease, an infection that works its way rapidly through the layers of tissue (the fascia) that surround muscles.
ESBL-producing bacteria (including E. coli)
VRE, an infection that actually spreads in the presence of antibiotics.
Enterococcus is a normally benign bacterium that lives in the intestine. Vancomycin-resistant enterococcus (VRE) is thought to be passed to people through contact with animals or by eating animal meat. Once the meat is eaten, the bacteria sit dormant in the person's gut until they come into contact with an antibiotic. At that point the VRE can spread to the rest of the body.
SARS infections in the Toronto area in 2003 were the result of hospital outbreaks.
How seriously do nosocomial infections impact the general public?
| U.S. cases
||2 million annually
|3 per minute = 10% American hospital patients|
|Deaths||80,000 (JAMA 7/2000)
| 9 per hour
Ignaz Semmelweis, who was so instrumental in promoting sound hygienic practices in the mid 1800’s recalled, “There were heart rendering scenes when [pregnant] patients knelt down, wringing their hands, to beg for a transfer [to the midwifery division]” and not have to deliver in the new wing of the Viennese General Hospital (1846). Semmelweis noticed that three times as many women were dying at the hands of the medical students than at the hands of the midwifery students from puerperal fever, commonly known at the time as, “the black death of the childbed”. Why? Because, after doing autopsies, the medical students proceeded on to assist in delivering babies, without washing their hands.
The New England Journal of Medicine reported 140 years later: “Hand washing is considered the single most important procedure in preventing nosocomial [hospital-borne] infections...[but] compliance of healthcare workers with recommended hand washing practices remains unacceptably low.... We found that, on the average, hospital personnel washed their hands after contact with [intensive care unit] patients less than half the time. Physicians were among the worst offenders.” When a case of nosocomial infection does develop, physicians routinely turn to drugs and antibiotics to try and reverse the failure to follow fundamental rules of cleanliness. Incidentally, there are tens of thousands of “accidental” deaths each year that are attributed to nosocomial infections contracted in hospitals.
Alas, as another 19th century health reformer noted, “All who leave the common track of custom, and advocate reform, will be opposed, accounted mad, insane, radical, let them pursue ever so consistent a course.” So it was with Dr. Semmelweis. The very next year after requiring every medical student to wash his hands with a chlorine solution before making an examination, the death rate at the Vienna Hospital plummeted. For the first time in its history, the mortality rate at the medical school fell below that of the school of midwives. But instead of being knighted, he was summarily dismissed from the Royal Society of Medicine. So, he lectured, he wrote papers, and he continued to be ridiculed. He then turned from academics to polemics. He published open letters to midwifery professors. “Your teaching... is based on the dead bodies of…women slaughtered through ignorance. If…you continue to teach your students and midwives that puerperal fever is an ordinary epidemic disease, I proclaim you before God and the world to be an assassin.”
He took to the streets with his circulars vainly hoping to alarm the citizens. “The peril of childbed fever menaces your life! Beware of doctors for they will kill you… Unless everything that touches you is washed with soap and water and then chlorine solution, you will die and your child with you!”
As a consequence, Semmelweis, at the age of 47, the father of three young children, was committed to an insane asylum in Vienna. He attempted to escape, but was forcibly restrained by several guards, secured in a straight jacket, and confined in a darkened cell. Quoting from the Bulletin of the History of Medicine, “He was not in the asylum for long. Thirteen days after admission he was dead.” From the autopsy report: “It is obvious that these horrible injuries were... the consequences of brutal beating, tying down, trampling underfoot.”
It is a sad comment that, even when common sense is backed up with scientific evidence, those who should know better still continue to rush for a hospital to treat some common ailment, exposing themselves or their loved ones to a host of lethal "germs", instead of first using some simple natural remedy in the relatively safe and healthier environment of their own homes.
One scientifically proven natural remedy is charcoal. Not only is it safe, but it has been demonstrated to effectively neutralize different "germs" and/or the toxins they release that trigger the vomiting, nausea, and diarrhea associated with them.