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Chapter 20 : Nosocomial and Laboratory-Acquired Infections
Nosocomial infections are those that are hospital acquired or hospital associated. According to some publications, nosocomial infections are estimated to complicate the course of 5 to 10% of all hospitalized patients in acute-care facilities. Nosocomial gastroenteritis can be defined as an acute infectious gastrointestinal illness acquired by a hospitalized patient, specifically unexplained diarrhea for 2 days, or the onset of infectious diarrhea somewhere in the hospital or medical center setting. Cryptosporidiosis has been implicated as one of the more important opportunistic agents seen in patients with AIDS. Immunoassays to detect Giardia antigen in feces have also been developed. The enzyme-linked immunosorbent assay is at least as sensitive as microscopic wet examinations. Fluorescence methods involving monoclonal antibodies have also proven to be extremely sensitive and specific in detecting Giardia lamblia in fecal specimens. Cryptosporidium infection and Giardiasis are discussed in the section on nosocomial gastrointestinal infections. Intestinal protozoa such as G. lamblia, E. histolytica, microsporidia, and the coccidia, particularly Cryptosporidium spp., cause human disease, and the protozoan cysts, oocysts, and spores can be accidentally transmitted from one person to another. The cysts, oocysts, and spores are resistant to many disinfectants. Of those currently available, ozone is the most effective protozoan cysticide, followed by chlorine dioxide, iodine, and free chlorine, all of which appear to be more effective than the chloramines.
Possible parasite transmission in a health care setting (nonlaboratory)
Possible parasite transmission in a health care setting (laboratory)
Potential exposures to laboratory-acquired parasitic infections a
Resistance to antiseptics and disinfectants, from most to least resistant