Nosocomial
An infection acquired by a patient in a healthcare facility that was not present or incubating at the time of admission.
The exam’s “tell” is a timeline: an infection that appears 48 hours or more after admission (or within 30 days of surgery) is nosocomial, whereas symptoms present on arrival are community-acquired. Stems often hand you a culprit device and want the matching bundle element: removing the indwelling catheter as soon as it’s no longer needed is the highest-yield CAUTI answer, daily chlorhexidine bathing plus prompt central-line removal cut CLABSI, and keeping the head of bed at 30–45 degrees prevents VAP. For the single best system-wide defense, the answer is still hand hygiene — every facility’s strongest, cheapest lever.
A classic trap blurs the term with its pathogen and transmission cousins: those describe the agent and its route, but “nosocomial” is defined by where the infection was acquired — inside a facility, after admission. Another: students grab alcohol gel for a C. difficile patient, but spores survive alcohol, so use soap-and-water handwashing under contact precautions. Hook: noso = disease, -comial = to care for — an infection born of the care setting itself.
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