Hospitals around the world are facing a serious crisis: the spread of infection among patients.
China is no exception.
“Wards have become breeding grounds for microbial pathogens,” asserts Bingwei Sun, M.D., Ph.D., a hospital infection management expert at Jiangsu University in Zhenjiang.
Even more worrisome, many of these pathogens are antibiotic-resistant superbugs. Globally, 70% of bacteria have developed resistance to antibiotics, which makes infection treatment more difficult and expensive — and makes solutions more urgent.
In China, an estimated 5% to 10% of hospitalized patients contract infections while hospitalized, including about 17% of patients in intensive care units. Patients infected by a superbug spend many extra days in the hospital, costing China ¥10-¥15 billion each year.
“Hospital-acquired infections add to the workload of medical staff, cause huge economic losses to the patients, and affect the economic and social benefits provided by hospitals,” notes Wenlong He of TianJin Medical University School of Public Health.
In recent years, Chinese health officials have committed to improving hospital infection control and increasing collaboration with the World Health Organization (WHO). Few have forgotten the 2003 outbreak of severe acute respiratory syndrome (SARS), which originated in China and spread to 19 countries.
The government is eager to protect its citizens from contracting and spreading viral and bacterial infections, and indeed, most hospital-acquired infections are preventable.
However, stopping this epidemic will require better hand hygiene, surface disinfection, and air-disinfection— in short, a combination of staff education and technological innovation.
On the education front, hospitals are working to better train doctors and nurses on infection-control practices. There is much room for improvement, as a survey of six Shanghai hospitals found “considerable shortcomings” in staff knowledge of infection control; only 2.8% of the doctors and nurses surveyed achieved a passing score on the anonymous questionnaire.
On the technology front, top hospitals are installing Novaerus air-disinfection units, which not only kill airborne bacteria and viruses but also dramatically reduce chemical pollutants. Popular in hospitals throughout Europe, Novaerus technology is now available in China via Hangzhou Dao Cheng, a distributor with more than a decade of experience selling medical equipment to public and private hospitals.
This article discusses the state of infection control in Chinese hospitals and the solutions that can safeguard patients while reducing the severe economic burden borne by hospitals.
How Infections Are Spread in Hospitals
On any given day, an estimated 1.4 million hospitalized patients worldwide have at least one healthcare-associated infection, such as pneumonia, meningitis, colitis, gastroenteritis, peritonitis, or sepsis. In China, lower respiratory tract infections are the most common, according to a study of 52 Chinese hospitals. Also common are infections of the urinary tract infection, upper respiratory tract, and surgical site.
At Chinese hospitals, the departments with the highest rates of healthcare-acquired infections are the surgical ICU, hematology, emergency, respiratory medicine, and neurology, according to a report on the progress of hospital infection control in China.
However, patients anywhere in the hospital are vulnerable, as infection is quite easily spread.
Twenty-four hours a day, pathogens accumulate and travel throughout the hospital, as visitors, staff, and medical devices come and go.
The web of transmission routes is vast, complex, and, notably, invisible. As one microbiologist noted about dangerous microbes: “Because we can’t see them, it is easy to forget that they are there.”
Viral particles launched by a sneeze — or by a change of bed linens — can hover in the air, to be inhaled by patients or to land on IV poles, wheelchairs, or stethoscopes. Pathogens deposited into a box of surgical gloves can hitch a ride, via central line, to a patient’s bloodstream, or via catheter to the urinary tract. Bacteria can travel from the bed rail of an infected patient to the hands of a nurse and from there, in numerous ways, to vulnerable patients.
Lethal microbes can flourish even on intact skin, so healthcare workers’ hands can become contaminated after seemingly “clean” procedures such as taking a patient’s pulse or temperature. The risk of transferring infection increases when staff change wound dressings, handle a ventilator, or otherwise come in contact with blood, body fluids, or mucous membranes.
Humidifiers, supply carts, stretchers, glucometers, IV poles, computers, and a doctor’s white coat can serve as vectors for transmission of pathogens as well.
However, these methods of transmission may not be foremost on the minds of hospital staff. As a report on Shanghai hospitals noted, “Clinicians (especially physicians) casually consider healthcare-associated infections (HCAI) as a speciality belonging to infection specialists who should be responsible for management and prevention of HCAI, thereby getting away from responsible conduct and liability.”
Part 2 coming soon.