Hospital-Acquired Infections Do Kill
Thousands of patients die each year from the deadly infections lurking in our filthy hospital wards. It's an epidemic raging out of control as antibiotics are rendered impotent. "Superbugs" are soaring and they are gathering strength all the time.
Every affluent country in the world where antibiotics are in widespread use is facing the superbug problem, but there is no doubt that it is reaching crisis level in Australia as it already is in Britain and the USA. British hospitals are the most dangerous in Europe for the potentially fatal bug, which prevents wounds from healing. Recent outbreaks in Australian hospitals were out of control necessitating closing wards and operating theatres and cancelling surgery. The main problem was VRE which is present in many healthy people but can cause serious illness in very sick patients. It can be transmitted on the hands of staff, patients and visitors.
The hospital-acquired infection situation in Australia is no better than England and may even be worse. In 1997 a medical journal reported that patients 'have more than a 1-in-10 chance of picking up infections in hospital'. A recent report on a related bacterium, MRSA, suggested that some hospitals in Australia lack infection control units (such as isolation units) which are common in the USA. One study on MRSA prevalence in Ireland, and Northern Ireland, found that 700 hospital patients were infected by MRSA during one fortnight in 1999.
A European study suggests that, among European countries, Ireland has one of the poorest records for MRSA infection, with only Italy, Portugal and Greece faring worse. In fact a report of European Anti-Microbial Resistance Surveillance System for 1999 showed a prevalence in Ireland which was more than 4 times that of Germany. Proper hand-washing, good antibiotic practice, effective ward cleaning and patient isolation are of crucial importance in reducing the spread of MRSA in hospitals. This is of concern for many Irish nurses come to Australia on working holidays and work in our hospitals.
Roll on 10 years. Has anything changed? NO! The superbugs are as deadly as ever.
Superbugs have been aided by two factors:
- First there is the indiscriminate doling out of antibiotics by doctors over the last 50 years which has allowed the micro-organisms to develop resistance with deadly efficiency. But even more shockingly...
- The superbugs have exposed the shameful fact that modern hospitals are simply not clean enough. Instead, they are a breeding ground for infections.
Many wards are filthy and too many medical staff disregard even the most basic rules of hygiene, such as washing their hands between patients. Hospital staff and managers fail to recognise that their disregard for the most basic rules of hygiene is a key factor in allowing this epidemic to take hold.
The weak points
- Quality of hospital care is a significant problem.
- Infection control surveillance nurses are non-existent.
- Sterilization equipment failures all too common.
- Hospitals disposing of hazardous waste recklessly.
All hospitals must have a mania for cleanliness like Scottish surgeon, Joseph Lister, who virtually "invented" hygiene in the 19th century. Patient safety is and must be paramount.
CLEAN UP YOUR ACT is the main advice we give hospitals!
MAIN CULPRITS
What is MRSA?
MRSA is a type of germ which is resistant to a wide range of antibiotics. Like other strains of Staphylococcus, MRSA can live on the skin without causing infection in most people. Hospital patients are especially vulnerable to MRSA and are too weak to fight it off. Staphylococcus aureus can cause actual infection and disease, particularly if there is an opportunity for the bacteria to enter the body, through a cut or an abrasion, for example. But newly emerging strains are causing life-threatening infections in otherwise healthy people. The antibiotic resistance problem arises because bacteria are constantly mutating, creating tiny changes in their genes. In order to stop it spreading you must remember that germs are normally passed by hand. It will normally be spread to patients from someone else in the hospital who has it. Effectively the MRSA bug "hitchhikes" a ride on someone's hand until it gets to your body. Once it has arrived it prefers to live in wounds.
What is C. difficile?
Clostridium difficile is a spore-forming bacterium, which is present as one of the "normal" bacteria in the gut of up to 3% of healthy adults. C. difficile is much more common in babies - up to two thirds of infants may have it in the gut, where it rarely causes problems. People over 65 are more susceptible to infection. It can cause illness when certain antibiotics disturb the balance of normal bacteria. Its effects can range from nothing in some cases to diarrhoea or severe, life-threatening, inflammation of the bowel.
What is GRE?
Glycopeptide-resistant Enterococci, are commonly found in the bowels of most people. There are many different species, but only a few can cause infections in humans - 95% of infections are caused by Enterococcus faecium and Enterococcus faecalis. These species are the two most common strains of GRE, which are resistant to glycopeptide antibiotics (vancomycin and teicoplanin). GRE commonly cause wound infections, blood poisoning and infections of the abdomen and pelvis.
Already had staph?
If you know that you have had Staphylococcus then you should tell your doctor and also inform the hospital if you are re-admitted. Hospitals may very well discriminate against you by refusing to admit you but you have a duty to your fellow patients to disclose it. You also have the right to demand of a hospital to be isolated away from the main ward area and if the hospital will not accommodate you indicates they have no infection-control protocols in place.
Some of the "Superbugs"
- MRSA: Methicillin-resistant Staphylococcus aureus - once curable by penicillin.
- C. DIFFICILE: Clostridium difficile - worst episode caused the deaths of 65 patients at one hospital - no patient was isolated - a disregard for basic hygiene.
- GRE: Glycopeptide-resistant Enterococci.
- VRE: Vancomycin-resistant Enterococcus.
- MDRAB: Multi drug-resistant Acinetobacter baumannii.
- MDR-TB: Multi drug-resistant tuberculosis - most of TB germs are MDR.
- XDR-TB: Extremely drug-resistant tuberculosis - lethal new form of TB and virtually impossible to cure which has exploded in Africa, Asia and Russia.
- KPC: Klebsiella pneumoniae carbapenemase - resistant to most of the common antibiotics in Brazil.
One example of infection control failure in Perth WA
- Man admitted to hospital for total knee replacement
- Acquires post-operative staph infection
- Has more surgery to wash out knee infection
- Then more surgery to re-do knee replacement
- Acquires another post-operative infection
- More surgery to wash out knee infection
- Drugs Chart disappears from patient's medical record
- Knee replacement removed altogether and knee fused straight
- 10 day hospital stay became 16 weeks
- Man left a cripple with knee stiff like concrete
- Hospital denies negligence.