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Proactive prevention measures limit nosocomial infections
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Proactive infection control efforts could be a major factor for limiting potential outbreaks in hospitals, according to research published in the American Journal of Infection Control.
“Hospital outbreaks of epidemiologically important pathogens such as respiratory viruses, gastrointestinal viruses and multidrug-resistant organisms (MDROs) are usually caused by lapses in infection control measures,” K.Y. Yuen, MD, of Queen Mary Hospital, Hong Kong, and colleagues wrote. “Besides the morbidity and mortality of these hospital-acquired infections, increased length of stay and expenditure, and even damage to a hospital’s reputation can pose notable consequences.”
Yuen and colleagues conducted a study of proactive infection control efforts at Queen Mary Hospital, a 1,700-bed hospital, from January 2010 through December 2014. Infection control measures included education of hospital workers and patients about their hand hygiene; active surveillance of possible infections; appropriate patient isolation and decolonization; and follow-up with contacts. The researchers then compared nosocomial infections at the facility with figures from six other acute regional hospitals in Hong Kong’s computerized surveillance system to see the possible impact of these measures.
K.Y. Yuen
Queen Mary Hospital totaled 322 nosocomial infection cases (excluding MRSA and Clostridium difficile) during the study period, 79.2% due to viruses and 20.8% due to MDROs. Of these cases, respiratory syncytial virus (18.9%), parainfluenza virus (18.3%) and norovirus (14.6%) were the most common, Yuen and colleagues wrote.
Only one case involved a cluster of three or more patients (five) considered an outbreak by the study standards, which equated to 1.48 hospital outbreaks per 1 million patient discharges. During the same period, the other six included hospitals totaled 118 nosocomial infection outbreaks, ranging from 5.66 to 58.85 outbreaks per 1 million discharges.
The researchers said the number of outbreaks at Queen Mary Hospital was 16 times lower than the total number of outbreaks for the other six hospitals (Rate Ratio = 0.061; 95% CI, 0.001-0.341), and that hand-hygiene compliance increased from 66.4% in 2010 to 76.2% in 2014. The number of outbreaks per 1 million patient-days was 15 times lower at Queen Mary Hospital than the total for all the other hospitals (Rate Ratio = 0.068; 95% CI, 0.002-0.376).
“It is very difficult to minimize the number of hospital outbreaks over a sustained period, and 322 episodes of nosocomial-acquired cases were detected during the 5-year period through our syndromic and computerized surveillance system that allows early detection of the first hospital-acquired case,” the investigators wrote. “Nonetheless, only one cluster of five patients with respiratory syncytial virus was observed during our study period. Therefore, the low number of hospital outbreaks most likely reflects the effectiveness of our timely implementation of enhanced infection control measures in response to the first patient instead of a failure to detect outbreaks.” – by David Jwanier
Disclosure: The researchers report no relevant financial disclosures.
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