Infections in hospital; Most people expect hospital treatment to make them better. But for some, a stay in hospital can actually make them sicker. Their wound might get infect after an operation or they might get a blood infection; so as a result of a medical procedure. Our study, published today in the international journal Antimicrobial Resistance and Infection Control, found one in ten adult patients in hospital with an acute (short-term) condition had a health care associated infection.
Most of these infections can be prevented. So it is important to know what type of infections they are; so how common they are and which patients get them. Once we have this information, they can work out a way to prevent them. Left uncheck, these infections can make already sick patients sicker, can divert hospital resources unnecessarily, and can kill. Most hospitals in Australia have ongoing surveillance for specific infections, such as wound and bloodstream infections.
Infections in hospital
Some states have well coordinated programs like the Victorian program VICNISS; leading to detail data on health care associated infections. This data is then used to inform hospital strategies on how to prevent infections. However, this type of surveillance method requires extensive resources and does not capture all infections that occur in a hospital. Instead, they conduct a “point prevalence” survey, which takes a snapshot of the current situation on any given day. This is less resource intensive than ongoing surveillance and it provides valuable information on the distribution and occurrence of allinfections in a hospital.
In Europe, the European Centre for Disease Prevention and Control co-ordinates national point prevalence studies every four years. These have provide valuable insight into the burden of health care associated infections. They have also use to track the emergence of multi-drug resistant organisms in Europe. The US, Singapore and many other countries also run them.
This is important as most hospitals do not normally look for pneumonia or urinary tract infections; also there is no routine statewide or national surveillance for these. Our findings mean these infections are commonly occurring but undetected. A potential source of information on these types of infections is hospital administrative coding data. However, these codes were mainly design for billing purposes; also have been shown to be unreliable when it comes to identifying infections.
Large intravenous drip
We also found patients with a medical device, such as a large intravenous drip, or urinary catheter (a flexible tube inserted into the bladder to empty it of urine), were more likely to have an infection than those who did not. Intensive care units treat patients who are gravely unwell and at greater risk of infection. So it was unsurprising to find that 25 percent of patients in intensive care units; who had a health care associated infection.
For the first time in 34 years we have a glimpse of how common health care infections are in Australian hospitals. Although the only other previous study was larger, a major strength of our study is that they use the same two trained data collectors to collect the data from all hospitals. This reduce the potential inconsistency in finding infections that might occur if hospital staff collect their own data.
As one of the authors has previously noted, a major gap in Australia’s effort to combat health care infections, and the emergence of multi-drug resistance organisms, is the lack of robust national data.This means we cannot measure the effect of national policy or guidelines despite significant investment. In the absence of a national surveillance program, they recommend that large-scale point prevalence surveys, including smaller hospitals, specialist hospitals and the private sector be undertaken regularly. Data generated from these studies could then be use to inform and drive national infection prevention initiatives.