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No easy answer to HAIs, says top microbiologist


13 November, 2007  

There is no single, simple or cheap way to prevent hospital-acquired infections, says a leading microbiologist.

Writing in the Irish Times, Professor Hilary Humphreys, consultant microbiologist at Dublin’s Beaumont Hospital, said hospital infection had become a major issue for Ireland’s health service.

“There is always a potential risk that even the most routine of procedures could result in a complication. No procedure, no drug and no aspect of healthcare is without some risk,” Professor Humphreys said.

“However, if the admission is appropriate, that risk will be more than counterbalanced by the benefit for the patient and their family in terms of improved health. Hospital infection is an example of a healthcare complication which affects a small minority.

“Today, we are stretching ever further the boundaries of healthcare, with major and welcome new developments. But at the same time we expose a new group of vulnerable patients, who previously would have died, to the possibility of acquiring hospital infections,” he said.

“In addition, the increasing longevity of patients, and the use of some drugs that weaken the body’s own defences against infection, means that there is a continuous need to improve our preventative measures.”

Professor Humphreys noted that in 2006 most acute hospitals in Ireland took part in the Hospital Infection Society HAI prevalence survey. Some 5% of patients had a hospital infection, 10% due to MRSA, the rest to other microbes.

“The majority of hospital infections are treatable and while there is considerable scope for improving our approach to preventing hospital infection in Ireland, we will never achieve a zero rate,” he stated. “What is not clear at present is exactly how much of the 5% of hospital acquired infections is preventable.”

There was no single, simple, cheap solution to the HAI problem, especially as this had been largely ignored in Ireland’s health system until recently. The Department of Health and Children and Health Service Executive had now prioritised this area.

However, he went on: “We have an enormous amount to do if we are to equal the success of countries such as the Netherlands, Switzerland, Denmark and the other Scandinavian countries.

“Any strategy to minimise infections in hospital must include the education of all healthcare workers on what is appropriate practice, as well as the education of patients, visitors and the public,” he averred. Investments were also needed in facilities and personnel.

“The practice of housing six complete strangers in a room together harks back to an era when patient privacy was not considered important and when patients were less complicated in terms of their susceptibility. Future hospitals are likely to have at least half of all beds in the form of single rooms with appropriate isolation facilities,” Professor Humphreys said.

“We need a hospital capital development programme to ensure this occurs. Moreover, many of our hospitals do not have the relevant expert personnel.”

Health Service Executive