Ruminations

Blog dedicated primarily to randomly selected news items; comments reflecting personal perceptions

Thursday, January 07, 2010

Hospital-Acquired Infections

There was a time when the wealth-privileged and those with gold-plated health insurance or people whose illness was sufficiently dire as to require their isolation from other hospital patients, were the only ones who rated private hospital rooms. All other patients, according to their insurance coverage, or supplemental insurance coverage, were assigned to sharing a room with another patient, or to hospital wards with four or six patients to a room and sharing common bathroom facilities.

Back when hospitals appeared to be better funded than they are now, the population not quite as dense as it is now, and the necessity to ensure that hospitals were kept in hygienically cleansed states through the work of fully-staffed cleaners was more reliable things may have been different. And when hospital-acquired infections seemed not to pose the problems that they now do.

On the other hand, back in those tobacco-unenlightened days, both patients and hospital staff were permitted to smoke in hospitals. That, at least, has seen a great improvement, given what we now know and acknowledge about the consequences of tobacco use and exposure to second-hand smoke. So we have come some way, in some ways, but in others, perhaps not so much.

In new research discoveries published in Microbiology, University of Ireland (Galway) scientists appear to have come to the conclusion that while full-strength disinfectant containing benzalkonium chloride is highly effective in eradicating bacteria, when the disinfectant is diluted bacteria manage to survive and build resistance both to the disinfectant itself and to antibiotics.

In Canada, it is estimated that some 225,000 hospital-acquired infections occur on an annual basis. And these infections are the cause of between 8,000 to 12,000 needless deaths. Most people believe they enter hospital to be cured of whatever ails them, not to become infected with something so dire they will never exit the hospital of their own accord.

New research undertaken by Queen's University with respect to drug-resistant infections (superbugs) such as C.difficile and staphylococcus aureus, leads the research team to a novel conclusion: build new hospitals with private rooms only, to isolate patients from one another and the propensity for passing infections from one patient to another will be eliminated.

Evidently the risk of infection with one of three identified 'superbugs' increases exponentially the more sharing of hospital rooms. With patients being exposed to as many as six roommates having a 77% to 90% higher risk of being infected than those privileged in their hospital stays with a single, private room.

Shared bathrooms and furnishings among patients appear the likeliest mode of infection spread, along with hand-to-hand contact. Patients are more vulnerable than people in the general population because of their impaired immune system as a result of disease, or medical intervention, with surgical wounds or IV tubes, or chemotherapy regimens.

It will be expensive to build such hospitals - or new wings onto already-existing medical facilities - to an already cash-strapped health system. But the alternative is the acceptance, and likely a gradually increased incidence of hospital-acquired infections which are themselves costly to treat, and the outcomes of which are too often too deadly.

In the final analysis, it will be the balance between a greater monetary expenditure to upgraded infrastructure, or the acceptance in society and among those in the medical community, and government, of needlessly wasted lives.

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