Resistant germs infection in the hospital

Resistant germs: Infection in the hospital.

(26.08.2010) After the deaths of the three infants in the University Hospital of Mainz, the problem of bacterial contamination in German hospitals have again brought on the agenda, now sees the black-yellow federal government forced to act: New guidelines for hospital hygiene should come.

Up to one million patients become infected according to the Allianz report „Sick in the hospital“ Annually in German hospitals with dangerous germs, often with fatal consequences. In particular, the huge increase in infections caused by multidrug-resistant staphylococci (MRSA) is an expression of poor hygiene.

But the push towards new guidelines for hospital hygiene is being solved by the Dutch microbiologist of the Medical Spectrum in Twente and experts in hospital hygiene. Ron Hendrix, in the interview with the station ntv only a loud laugh. Because in his opinion, the German directive is very good at this point, only their implementation leaves much to be desired.

In the Netherlands, infections by MRSA bacteria are almost never seen in hospitals, although there are no comparable legal guidelines. Here the hygiene rules are created individually by experts for each hospital and are based essentially on the practical requirements. For this reason, each hospital has its own microbiologist, who advises staff on hygiene issues and also ensures that antibiotic use is kept within reasonable limits. The relevant specialists are closely involved in the daily processes of patient treatment and communicate intensively with the various specialists. This approach is favored by the structure of hospitals in the Netherlands, as small clinics that focus on one subject area, as is often the case in Germany, tend to be the exception. So, according to Dr. Hendrix the specialists of the most diverse discipline regularly and advise each other. „It is normal for us to have a microbiologist consult a doctor on infectious diseases and tell them if an antibiotic is to be used. For example, a surgeon may not be an expert in the field of antibiotics“, said the microbiologist and head of the Euregio network to ntv.

The massive or partially irrational use of antibiotics in German hospitals is from the point of view of Dr. med. Hendrix also a problem. Here, the doctors in the Netherlands come out with a fraction of the amount used in Germany due to the intensive advice given by microbiologists. With the advantage that fewer bacteria develop resistance to antibiotics. „Only a few days ago, a bacterium was reported that no longer responds to our current antibiotics. That is why antibiotics are rarely prescribed in Holland - and if so, then as old as possible, for example penicillin“, stressed Hendrix. In the opinion of the expert, this is another reason why infections with the wound germ MRSA occur about 20 times more frequently in German hospitals than in the Netherlands.

When asked what solutions are available for the hygiene problem in German hospitals, Dr. Ing. Hendrix only one way out: more money must be invested in hygiene professionals and microbiologists. Similar view is also the „German Society for Hospital Hygiene“ (DGKH) and therefore wants from the state side of the appointment of hygiene professionals in the hospitals mandatory. The advantage of such investments would be that they could be saved in the course of the saved costs for the treatment of nosocomial infections (hospital infections). „double and triple“ would be profitable, said the microbiologist dr. Hendrix. At present, only five percent of German hospitals have a sanitary doctor.

Patients considered potential carriers of MRSA will be tested for the pathogen in the Netherlands as soon as they arrive at the hospital. If the result of the test is positive, the patients come in single rooms and are only treated by nurses in protective clothing. The risk groups that must in any case undergo an MRSA test when admitted to hospital include all persons who have previously been MRSA carriers themselves or have had contact with one, who have recently received inpatient care in the hospital, who are chronically dependent or dialysis dependent or who to suffer from chronic open wounds. In addition, all residents of retirement or nursing homes are at risk. Patients transferred from a German hospital to the Netherlands also belong to the risk group and will be quarantined on arrival, according to the Dutch microbiologist dr. Hendrix, because „Although German doctors operate very well, we are afraid of infection.“

The Dutch system, however, can not simply be transferred to Germany because of the different medical landscape, according to the expert, also involved in the Euregio network, Alexander Friedrich from the Institute for Hygiene at the University of Münster, but „we have to adapt it.“(Fp)

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Picture: Erich Werner