Which procedure is most associated with nosocomial infection?

Urinary catheterization is particularly associated with nosocomial infections, primarily urinary tract infections (UTIs). When a urinary catheter is inserted, it creates a direct pathway for bacteria to enter the bladder, bypassing the body's natural defenses. The longer a catheter remains in place, the higher the risk for infection due to the potential for biofilm formation on the catheter surface and the introduction of pathogens from the external environment.

This risk is significantly heightened in hospital settings where patients may have weakened immune systems or other complicating factors. The prevalence of catheter-associated urinary tract infections is well documented, making urinary catheterization the procedure most closely linked to these types of infections in a nosocomial context.

In contrast, while procedures such as appendectomy, cholecystectomy, and hernia repair can also be associated with infections, they typically involve surgical wounds or intra-abdominal complications rather than direct pathways for bacteria as seen with catheterization. These surgical infections, while significant, do not occur with the same frequency as UTIs related to catheter use, thus highlighting the unique risk posed by urinary catheterization in hospital environments.