Sick by hospital germs

Sick by hospital stay: Dangerous multidrug-resistant pathogens.

(24.08.2010) Germs are a serious problem, especially in hospitals, as the death of three infants in the Mainz University Hospital has brought to our attention. According to the Allianz report "Sick in hospital" from 2007 in Germany, between 500,000 and one million people in hospitals are infected with germs every year.

The Europe-wide study comes to the conclusion that about one in ten patients in the hospital infected with dangerous germs. About 15,000 people die each year as a result of such an infection, said a spokesman for the Berlin University Hospital Charité. Rarely, drug-resistant pathogens are responsible for the disease, in most cases, other germs are the cause of the infection. "Multidrug-resistant pathogens that require special antibiotic treatment account for only ten percent of hospital infections, but other germs account for 90 percent," emphasizes Prof. Petra Gastmeier from the Charité Institute for Hygiene and Environmental Medicine: Two-thirds of hospital infections (nosocomial infections) are estimated The experts, however, avoidable if the current hygiene rules would only consistently implemented. „Compliance with hygiene standards really needs to be controlled by a specialist who is always in the house and keeps the other person awake because he keeps checking. But at present it is saved in hospitals gladly, just because no compulsion is there », so the statement of the speaker of the „German Society for Hospital Hygiene“ (DGKH), Klaus-Dieter Zastrow, in an interview with the „dpa“.

Therefore, the DGKH demands a state regulation, which requires each hospital to employ hygiene specialists, as is already the case in Berlin, Saxony, Bremen, North Rhine-Westphalia and the Saarland. The representatives of the Berlin Charité, on the other hand, would prefer to extend their voluntary national surveillance program on hospital infections (KISS), which has been running for years. Both approaches have potential and as long as the numbers of hospital infections decline in the next few years, the patient does not care which method has led to the success.

Most nosocomial infections are caused by germs that the patients have brought with them, where in about 80 to 90 percent of cases, the germs are transmitted by the hands, said Frauke Mattner, expert in hospital hygiene at the German Society for Hygiene and Microbiology. Only around 50 percent of cases in which a thorough hand disinfection is required, is acted accordingly.

Particularly high is the risk of infection in intensive care units, where, according to the hospital hygienist of the University of Freiburg, Prof. Markus Dettenkofer, up to 15 percent of patients become infected with dangerous pathogens. Since most patients are already weakened due to their illness or operation anyway, severe consequences such as blood poisoning (sepsis), pneumonia, urinary tract infections, etc. often occur here.

The most common in the intensive care units is clearly the ventilator-associated pneumonia, i. H. a pneumonia caused by the transmission of germs in the context of artificial respiration. In this case, the pathogens can come from the area of ​​the intensive care unit and have been transmitted through hygiene defects into the oral cavity of the patient (exogenous infection path) or they come from the patient's own stomach and reach the oral cavity (endogenous infection). The latter type of infection route was by the „sedentary“ Position of the patient (30 - 45 degrees angle) in the past, however, already significantly reduced. In addition, urinary tract infections are particularly common in patients with bladder catheter, so that about 15 percent of them have to deal with such a nosocomial infection ...

Although their share of total hospital infections is still relatively low, experts believe that the increase in infections caused by multidrug-resistant pathogens is particularly worrying. They are a direct consequence of the often overly generous or even irrational use of antibiotics in the treatment of bacterial infections. (Fp)

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