Nosokomial

The Infection Protection Act (IfSG) defines infections as nosocomial (from "nosokomeion", Greek = hospital) if they occur in connection with an inpatient or outpatient medical procedure, unless the infection already existed beforehand (see §2 and §23 of the Infection Protection Act). As a rule, infections that occur 48 hours after hospitalization are considered nosocomial. In a broader sense, infections acquired in care facilities are also classified as nosocomial infections.

Risk factors: People who are particularly predisposed to a nosocomial infection are

• advanced age
• long inpatient stays
• Chronic diseases (e.g. diabetes mellitus)
• Immunosuppression (classic immunosuppressants, biologics)
• Foreign bodies (catheters, intravenous catheters, endotracheal tubes)

Nosocomial infections can be caused either by the body's own pathogens (e.g. bacteria that naturally colonize the skin or intestines) or by environmental germs (e.g. bacteria on surfaces or medical devices). Colonization of the skin or intestines, for example, often occurs first before a symptomatic infection develops. Pathogens can be transmitted via the hands of staff, for example. Hygiene deficiencies, especially in hand hygiene, play an important role in the spread of pathogens.

The occurrence of two or more infections where an epidemic connection (e.g. same ward at the same time, similar medical procedure) is probable or suspected (nosocomial outbreak) must be reported in accordance with Section 6 (3) IfSG, not by name, including all relevant outbreak information. The outbreak data is transmitted to the Robert Koch Institute (RKI ) via the respective regional office.

In 2020, 2,249 nosocomial outbreaks (Section 6 (3)) with a total of 29,997 cases from all federal states were transmitted via the reporting system. Of the 2,169 nosocomial outbreaks with pathogen information, 1,532 (71%) were caused by SARS-CoV-2 with a total of 23,562 cases. 637 (29%) nosocomial outbreaks were caused by other pathogens, of which 33 outbreaks (5.2%) were caused by bacteria and 594 (93.2%) by viruses. Parasites were identified as the cause of 10 outbreaks (1.6%).

No outbreaks caused by fungi were reported. Further information can be found in the Infectious Diseases Epidemiology Yearbook 2020. However, the number of nosocomial outbreaks is probably higher. Underreporting must be assumed.

1. Retrieved 15.2.2024: https://www.rki.de/DE/Content/Infekt/Ausbrueche/nosokomial/nosokomiale_Ausbrueche_node.html#doc5225310bodyText1