An overview of hospital acquired infections and the role of the microbiology laboratory

Asifa Nazir, S. M. Kadri


Every year, many lives are lost because of the spread of infections in hospitals. These nosocomial infections, also called hospital acquired infections (HAI) are infections that patients acquire during the course of receiving healthcare treatment for other conditions. HAIs are a cause of significant morbidity and mortality in patients receiving healthcare, and the costs direct and indirect of these infections deplete the already limited financial resources allocated to healthcare delivery.


Hospital Acquired Infection, Control, Microbiology

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Prevention of hospital-acquired infections. A practical guide 2nd edition. World Health Organization Department of Communicable Disease, Surveillance and Response. 2002. Available at:

Nosocomial infection. 2009. Avbailable at: http://en.wikipedia. org / wiki nosocomial_infection. Accessed June 2009.

Horan T.C, Gaynes R.P. Surveillance of nosocomial infections. In: Mayhall C.G eds. Williams and Wilkins Hospital epidemiology and infection control 3rd ed. Philadelphia: Lippincortt; 2004: 1659-1702.

Emori TG, Gaynes RP. An overview of nosocomial infections, including the role of the microbiology laboratory. Clin Microbiol Rev. 1993;6:428-42.

Scott RD. The direct medical costs of healthcare-associated infections in US hospitals and the benefits of prevention. CDC. 2008. Available at: Accessed 7 Jan 2009.

Plowman R, Graves N, Griffin MA, Roberts JA, Swan AV, Cookson B, Taylor L. The rate and cost of hospital-acquired infections occurring in patients admitted to selected specialties of a district general hospital in England and the national burden imposed. J Hosp Infect. 2001;47:198-209.

Osterholm MT, Hedberg CW, Moore KA. Epidemiology of infectious diseases. In: Mandell GL, Bennett JE, Dolin R, eds. Principles and practice of infectious diseases, 5th ed. Philadelphia, PA: Churchill Livingstone; 2000: 156-167.

Nosocomial infections and infection control in hospital. 2007. Available at: Infections.htm.

Weistein RA. Nosocomial infection update. Emerg. Infect. Dis. 1998:4(3):416-20.

Bonten MJ, Hayden MK, Nathan C, van Voorhis J, Matushek M, Slaughter S, Rice T, Weinstein RA. Epidemiology of colonisation of patients and environment with vancomycin-resistant enterococci. Lancet. 1996 Dec;348(9042):1615-9.

Mahieu LM, De Muynck AO, Ieven MM, De Dooy JJ, Goossens HJ, Van Reempts PJ. Invasive procedures Risk factors for central vascular catheter-associated bloodstream infections among patients in a neonatal intensive care unit. J Hosp Infect. 2001 Jun;48(2):108-16.

Dunn DL. Hazardous crossing: immunosuppression and nosocomial infections in solid organ transplant recipients. Surg Infect. 2001;2:103–10.

Practical guidelines for infection control in health care facilities. 2002. Available at:

McNicholas, S., Andrews, C., Boland, K., Shields, M., Doherty, G.A., Murray, F.E., Smith, E.G., Humphreys, H., & Fitzpatrick, F. Delayed acute hospital discharge and healthcare-associated infections: the forgotten risk factors. J Hosp Infect. 2011;78:157-8.

Mayon-White RT, Dual G, Kereselidze T, Tikhomirov E. An international survey of the prevalence of hospital acquired infection. J Hosp Infect. 1988:11:S43-8.

Britt MR, Burk JP, Nordguist AG et al. Infection control in small hospital: prevalence surveys in 18 institutions. JAMA. 1976;236:1700-3.

Prevention of hospital-acquired infections" in health care facilities. 2003. Available at:

The SENIC Project. Study on the efficacy of nosocomial infection control (SENIC Project). Summary of study design. Haley RW, Quade D, Freeman HE, Bennett JV Am J Epidemiol. 1980 May;111(5):472-85.

Wenzel RP, Thompson RL, Landry SM, Russell BS, Miller PJ, Ponce de Leon S, Miller GB. Hospital-acquired infections in intensive care unit patients: an overview with emphasis on epidemics. Jr Infect Control. 1983 Sep-Oct;4(5):371-5.

Wiblin RT, Wenzel RP. The infection control committee. Infect Control Hosp Epidemiol. 1996;17:44-6.

National Nosocomial Infections Surveillance (NNIS) System, Centers of Disease Control and Prevention. National Nosocomial Infections (NNIS) report. Am J Infect Control. 1996;24:380-8.

Russell, Hugo. Does the Architecture of Hospital Facilities Influence Nosocomial Infection. In: Ayliffe, G.A.J., Babb, J.R., & Taylor, L.J. Eds. Hospital-acquired infection. Principles and Practice. 3rd ed. Butterworth and Heinemann: Oxford; 1999: 109-121.

Guidelines on Prevention and Control of Hospital Associated Infections World Health Organization Regional Office for South-East Asia SEA-HLM-343. 2002. Available at: Accessed January 2002.

McGowan JE, Metchock BG. Basic microbiologic support for hospital epidemiology. Infect Control Hosp Epidemiol. 1996;17:298–303.

McGowan JE Jr. Communication with hospital staff.In: Balows A, Hausler WJ Jr, Herrmann KL, Isenberg HD, Shadomy HJ, eds. Manual of Clinical Microbiology. 5th ed. Washington DC: American Society of Microbiology; 1991: 151-158.

Wiblin RT, Wenzel RP. The infection Control Cpommittee.Infect Control Hosp Epidemiol. 1996:17:44-46

Boyce JM. Hospital Epidemiology in smaller hospitals. Infect control Hosp Epidemiol. 1995; 16:600-6.

Kalenic S, Budimir A. The role of microbiology laboratory in healthcare-associated infection prevention. Int J Infect Control. 2009;5:i2.

Kolmos HJ. Interaction between the microbiology laboratory and clinician: what the microbiologist can provide. J Hosp Infect. 1999 Dec;43Suppl:S285-91.

Michael A. Pfaller and Loreen A. Herwaldt. The Clinical Microbiology Laboratory and Infection Control: Emerging Pathogens, Antimicrobial Resistance, and New Technology Clinical Microbiology Laboratory and Infection Control. 1997;25:858-70.

Laboratory role in the management of hospital acquired infections Wilson MP, Spencer RC. J Hosp Infect. 1999 May;42(1):1-6.

Mallison, G. F., and R. W. Haley. Microbiologic sampling of the inanimate environment in U.S. hospitals. Am. J. Med. 1981;70:941-76.

Centers for Disease Control. Guideline for handwashing and hospital environmental control. Infect. 1985;7:231-42.

T. Grace Emori and Robert P. Gaynes. An Overview of Nosocomial Infections, Including the Role of the Microbiology Laboratory. Clinical Microbiology Reviews. 1993 Oct;6(4):428-42.

L. Barth Reller, Melvin P. Weinstein et al. Role of Clinical Microbiology Laboratories in the Management and Control of Infectious Diseases and the Delivery of Health Care. Clin Infect Dis. 2001;32(4): 605-10.

R. Peterson, John D. Hamilton, Ellen Jo Baron et al. Role of Clinical Microbiology Laboratories in the Management and Control of Infectious Diseases and the Delivery of Health Care. Lance Clinical Infectious Diseases. 2001;32:605-11.

Bouza E. The role of the microbiologist in the control of nosocomial infection and antibiotic therapy. Enferm Infecc Microbiol Clin. 2003 May;21 Suppl 2:32-6.