Death-bearing multidrug-resistant germs in clinics

04/11/2015

Again and again, patients in hospitals become infected with so-called multi-resistant germs, against which hardly any antibiotic is effective anymore. But where do the dangerous pathogens come from? Researchers at Leipzig University Hospital answered this question and came to the conclusion that the germs are often introduced by travelers from countries with a high prevalence of multidrug-resistant bacteria. Experts are calling for better hygiene measures in German hospitals and patient screening based on the Dutch model.

Tourists haul in multidrug-resistant bacteria unnoticed
Between May 2013 and April 2014, the Leipzig scientists compared the data of 225 people who had previously lived in areas with a high prevalence of dreaded germs. As it turned out, almost every third of a total of 200 travelers had resistance to coli bacteria. Among them were eleven of 15 people who had traveled to India. Although none of the study participants fell ill with the germs, however, the danger of introducing the dangerous pathogens unnoticed into a hospital was high, according to infectiologist Christoph Lübbert and his colleagues in the journal "International Journal of Medical Microbiology". Therefore, the fight against the germs must be conducted globally. "Active surveillance and contact isolation precautions should be recommended for access to healthcare facilities, especially for patients who have traveled to India and Southeast Asia over the past six months," the researchers write.

The Foundation for Patient Protection does not go far enough with this recommendation. She calls for screening for all patients admitted to a clinic. "We're after the infection," said Foundation Board Eugen Brysch told the news agency "dpa". The risk of developing a multidrug-resistant infection is currently high. "This is a basic problem that we have to face." Brysch advises that, as a precaution, each patient should first assume that he has a dangerous germ to infect others with.

Peter Walger, spokesman for the German Society for Hospital Hygiene (DGHK), opposes a more general screening. Because such an investigation would cause high costs and a Datenwust. A screening should only be used where it makes sense. "We do not need to know who runs around with multidrug-resistant germs because they pose no danger. If you stick to the basic hygiene, you can also control the germs well, "said Walger to the news agency. Rather, one had to make sure that those patients who were carriers of multidrug-resistant bacteria were identified when admitted to hospital. "We say: We want to test high-risk patients." In addition to travelers, this included patients who were transferred from other clinics within Germany.

German hospitals are allowed to decide themselves on preventive measures against germs
The legal situation allows each clinic to decide for itself how to prevent the germs. For example, the Gemeinschaftsklinikum Mittelrhein in Koblenz last autumn launched an action under the motto "Touch hearts, not hands", in which the hospital's children's hospital announced that parents and patients would no longer shake hands give.

Dutch hospitals are handling the germ-risk quite differently. Although there is no general screening, every patient who belongs to a risk group is tested, explains Alexander Friedrich, director of the Institute for Medical Microbiology and Hospital Hygiene of the University Hospital Groningen in the Netherlands to the news agency. The Dutch health care system is geared to infection prevention. "In Holland, we focus on hygiene, wise antibiotics treatment and the visualization of pathogens before anyone falls ill." In every hospital, there is also a full-time hospital hygienists, in Germany, this is not the case so far.

According to Friedrich, patients from Germany are always considered to be at risk due to the lack of infection prevention. In the Netherlands there are only sporadic imported germ colonies, but no national outbreaks as in Germany.

In the border regions the differences hardly come to light, since there are almost no multi-resistant germs. "We want to ensure that this region is the last in which these pathogens spread," said Friedrich. "The rest should be able to orient themselves instead of simply accepting the germs." (Ag)