Emerging and re-emerging infectious agents of nosocomial diseases – The need for review of hospital policy and control strategies

Nosocomial infections (NIs, now referred to as Healthcare-associated infections, HCAIs) are diseases that essentially originate from the hospital and may be disseminated via biologic or inanimate agents in the healthcare center. They occur globally and constitute major hazards in healthcare institutions resulting in significant morbidity, mortality and increased hospital stay, and high socio-economic cost. Between 3 and 21 percent (average range, 5 – 9%) of all hospitalized patients are affected by HCAIs each year in various communities worldwide; while critically ill, trauma or immunocompromised patients (e.g. those requiring multiple life – saving invasive procedures or immunosuppressive therapy) are hardest hit. The increasing involvement of multiple drug-resistant strains of a large spectrum of emerging and re-emerging infectious agents of NIs complicate morbidity, management and impose serious burden on the patients and relations. Hospital workers, patients, materials or equipments and hospital procedures constitute major factors of transmission mechanism of HCAIs. However, the incidence and socioeconomic impact of NIs (though estimated to be high) are rarely investigated in sub-Saharan Africa (including Nigeria) due to poor healthcare facility and low capacity. There is need for increased awareness on HCAIs and adoption of enduring hospital policy and effective control measures that will take cognizance of emerging trends of nosocomial agents and transmission mechanism to reduce morbidity, mortality and socio-economic impact associated with HCAIs.