Abstract
Introduction: Nosocomial infections or hospital-acquired infections (HAIs) are contracted in hospitals or other health-care facilities. The immune response of the host against these infections may cause sepsis. The sepsis due to HAI is also called nosocomial sepsis or hospital-acquired sepsis (HAS). Sepsis may be associated with organ dysfunction, longer stays in hospitals, morbidity, and mortality. HAS is now considered a global critical health concern, and this condition is worsening due to the development of antimicrobial resistance among microorganisms. Furthermore, implementing infection prevention and control strategies does not reduce the prevalence of hospital-acquired infections, probably due to the presence of endogenous pathogens. The main objective of this study is to provide a piece of information related to nosocomial infections and sepsis. This study focused on associated microorganisms, epidemiology, risk factors, pathophysiology, and associated adverse effects of HAS. Additionally, management strategies for HAS are also discussed. This information can be useful in clinical practice. Methods: For this study, online literature was accessed from various sources like Google Scholar, Science Direct, PubMed, Scopus, and Web of Science. Including this, websites of different agencies were also accessed. Authors used different keywords such as: hospital-acquired infections, sepsis, epidemiology, risk factors, symptoms, pathophysiology, management approaches for HAS, etc., to search the relevant information. Results: The dysregulated immune response to hospital-acquired infections causes nosocomial sepsis that may lead to morbidity, organ dysfunction, and death. Epidemiological data highlighted that sepsis is associated with about 11 million worldwide deaths. Both Gram-positive and Gram-negative bacteria cause infection in hospitalized patients, but Staphylococci, Pseudomonas, and Escherichia coli (E. coli) are found as primary pathogens. Furthermore, antimicrobial-resistant microbes are creating challenges for the antimicrobial-based treatment. Within healthcare facilities, intensive care settings are suggested as key hotspots for antibiotic-resistant microorganisms. Discussion: HAS remains a major public health challenge, causing millions of deaths worldwide every year. It is associated with multiple risk factors such as old age, weakened immune systems, lack of adequate hygiene practices in healthcare settings, and clinical and surgical interventions. Although the prevalence of nosocomial sepsis is observed both in developed and underdeveloped countries, lowand middle-income countries possess a higher risk. The management approaches for nosocomial infections and nosocomial sepsis depend on the type and severity of the infection. These include early detection, use of antibiotics and fluids, etc. Further management approaches include controlling the transmission of infections, antibiotic stewardship, identification of sepsis biomarkers, etc. Conclusion: HAS is a critical health concern. More patients are exposed to infections during hospital stays rather than outpatient visits. Staphylococci, Pseudomonas, and E. coli are identified as key pathogens. It is a treatable and manageable clinical condition. Although early detection plays a key role in managing the HAS using antibiotics, rising incidences of antimicrobial resistance among microorganisms are limiting the antibiotic-based treatment options. Nowadays, researchers are also focusing on the identification of alternative antimicrobial agents, such as antimicrobial peptides, to manage infections caused by antibiotic-resistant microorganisms.