Hygiene Regulation effective against hospital germs?

Hygiene Regulation: miracle cure in fight against hospital germs?

08/02/2011

The hygiene scandal at two clinics in Hesse has drawn the public's interest in a topic that has been the subject of intense debate in professional circles for a long time. The infection with so-called hospital germs.

According to the health authorities, up to 600,000 people in Germany suffer from an infection with the so-called hospital germs every year during their stay in the hospital. According to the federal government, up to 15,000 people die each year from such an infection. The German Society for Hospital Hygiene (DGKH) even expects a significantly higher number of annual deaths. But although the problem has long been known, so far has done little. However, in view of the recent hygiene scandals in Hesse, public pressure is growing and the German government has also long been calling on countries to issue a corresponding hygiene ordinance.

Hygiene regulation so far only in seven federal states
So far, however, only seven of the 16 federal states have set up a hygiene ordinance to meet the hygienic needs in the hospitals and to intensify the corresponding control. As the eighth federal state, Hesse wants to issue a hygiene ordinance this year as well, explained the Hessian social minister Stefan Grüttner. Although no patient was at risk due to the recently discovered contamination of surgical instruments in the Fulda and Kassel hospitals, the hygiene deficiencies could have been avoided with a corresponding hygiene ordinance, explained the Hessian Minister of Social Affairs. Studies and pilot projects have shown that even strict compliance with hygiene regulations can significantly reduce infection rates. Also Dr. Klaus-Dieter Zastrow, hygiene expert at the DGKH, emphasized how important a uniform hygiene regulation would be for all German hospitals.

800,000 infections annually due to hospital germs
The DGKH expert explained that „under the name of hospital germs“ Although not only pathogens that are found in clinics are understood, but germs that every person carries around with them. However, the infection risk in the hospitals is particularly high, since the pathogens can enter the body through open wounds, for example, and the immune system of the patients is usually already weakened anyway. The problem arises when the germs „get into areas of the body where they have no business, for example into the blood or into sterile spaces such as the bladder and lungs“, said Petra Gastmeier, director of the Institute for Hygiene and Environmental Medicine at the Berlin Charité. According to Klaus-Dieter Zastrow, on average, about five percent of hospital patients are infected with the so-called hospital germs, which, in contrast to the information provided by the Federal Government, would not be equivalent to 600,000 but more than 800,000 diseases annually. According to Zastrow's estimates, between 20,000 and 40,000 patients die in Germany a year as a result of infections with hospital germs.

Threatening infection by multi-resistant pathogens
According to the DGKH expert, the multidrug-resistant pathogens such as MRSA, VRE and ESBL, which are resistant to almost all common antibiotics, are particularly threatening for the health of patients. „They do not cause any infections other than the other germs, but these are much harder to treat and are usually much more severe“, because the attending physicians „to look for an (effective) antibiotic for longer“ Zastrow explained. Petra Gastmeier added as justification for the fluctuating information of the affected patients that the „Assessment of deaths (...) very difficult“ be. Because often one could not determine exactly whether „a patient in the hospital died (is) because he had a certain infection“ or if he succumbed to his other illnesses.

Compliance with hygiene regulations could prevent infections
Overall, the experts assume that a large proportion of infections could be avoided by better hygiene measures. Not only in the operating room, but also during the visit, the wound inspections and the hospital as a whole, the hygiene regulations should be strictly implemented. However, the experts also emphasize the importance of uniform regulations and their monitoring in order to achieve a functioning, nationwide implementation of hygiene measures. In addition, the patients are increasingly encouraged to deal with the hygiene situation in the visited hospital. Although according to the experts, the patients can only contribute little to hygiene, they should inform themselves about the hygiene measures there before a planned hospital stay. According to the health adviser of the consumer center in Karlsruhe, Julia Nill, is „the recording interview (...) a good way to talk about hygiene.“ In addition, give it „in each hospital with more than 400 beds, a hospital hygienist who can be asked for an appointment.“ In the smaller clinics, a specialist nurse for hygiene is approachable.

Patients should inform themselves about hygiene standards
However, not only because of one „a hospital has a hygiene management department“ automatically „the hygiene in the house excellent ordered“ be, said Petra Gastmeier. For the patients „More meaningful are quality reports or websites, which show in which departments with which regularity the occurrence of infections or of multidrug-resistant pathogens is statistically recorded and analyzed“, according to the expert. Even though the patients have hardly any direct influence on the hospital hygiene, the discussion with the responsible persons is particularly important, as this is a clear signal that the hygiene of the patient is important. „The more patients ask, the more people are sensitized“, Petra Gastmeier explained. And finally, not only could the costs of treatment be significantly reduced by better implementation of the hygiene measures, but also the risk of serious illnesses would be significantly reduced in terms of the patients, the experts explained. (Fb)

Read about hospital, hygiene and germs:
Hessian hygiene regulation later this year?
Again contaminated surgical cutlery in Hesse
Contaminated surgical instruments at the Fulda Hospital
Every tenth hospital treatment hurts

Picture: Gerd Altmann