Hospital Infections: Causes And Prevention

They kill twice as many as road accidents. And they are not rare at all: in Italy 8 percent of hospitalized patients caught an infection in hospital, especially after surgery. It is a waste of health and human lives.

Hospital Infections

Hospital infections, unfortunately, are not a rarity. They kill twice as many as road accidents, and approximately 8% of patients hospitalized (or in a clinic, in a nursing home for the elderly, in any healthcare facility) contract an infection associated with healthcare procedures. And one in five infections is linked to surgery.

Surgical wound infections, in fact, represent the second most frequent type of infection contracted in hospitals, after respiratory tract infections and immediately before urinary tract infections. To deal with this problem, a group of Italian experts has outlined a series of fundamental basic rules to reduce the risk of infection following surgery. I am following the indications of the World Health Organization (WHO) and the Centers for Disease Control and Prevention of Atlanta (CDC).

Causes

Among the most frequent causes of healthcare-associated infections are:

• The reduction of the immune defenses following the weakening of the body or diseases concomitant to the one for which one is hospitalized.
• Poor environmental hygiene and prevention activities in the hospital facility.
• The emergence of bacterial strains resistant to antibiotics, also due to their excessive and uncontrolled use
• The introduction of new health technologies, although they lead to an improvement in therapies and surgical interventions, in an initial phase can lead to an increase in the risk of healthcare-associated infections.

Types Of Hospital Infections

Most hospital infections involve:

• The urinary tract
• The respiratory system
• Surgical wounds
• Systemic infections, such as sepsis and bacteremia

People At Risk

The people most at risk for hospital infections are certain patients, especially when hospitalization times become more extended. But the dangers of infections also concern doctors, healthcare personnel and visitors.

How To Prevent Infections In Hospital

There are mainly two preventive procedures that have become more important in our country in the last decade: skin disinfection before surgery and hair removal, where necessary.

The international guidelines underline the importance of skin disinfection through the use of 2% chlorhexidine in alcohol, in sterile solution (so much so that these products are registered as drugs), to reduce the risk of bacterial presence on the skin as much as possible of the patient before the surgical incision” explains Mauro Pittiruti, surgeon of the Emergency Surgery Unit at the Gemelli Polyclinic Foundation in Rome.

Another important risk factor is represented by the incorrect execution of the trichotomy (removal and removal of hair from the operating room), a procedure which, if not correctly performed, can cause skin microtrauma and abrasions favoring bacterial proliferation in the surgical site. «This practice, if necessary, should only be carried out with electric clippers: micro scissors that cut the hair and do not shave it, without touching the skin. Razors and “do-it-yourself” hair removal, perhaps done at home the day before the operation, are not recommended, because during shaving or hair removal the skin can suffer from micro-lesions, which can be the site of colonization by microorganisms,” adds Nicola Petrosillo, Director of the Clinical and Research Department in Infectious Diseases, “Spallanzani” Institute in Rome.

According to some estimates, the correct application of precise prevention measures could reduce the incidence of infections by up to 70%.

How To Avoid Hospital Infections

The National Federation of Nursing Professions suggests some dietary indications because food could cause problems related to anesthesia :

• It is recommended to fast from milk six hours before surgery and from clear liquids (water, fruit juice without pulp, tea, black and barley coffee, chamomile, and sugary drinks) two hours before any operating procedure requiring general anesthesia or regional sedation or analgesia.
• Eating fried, fatty foods or meat can prolong gastric emptying time.
• Alcohol should always be avoided.

Finally, some practical advice. It is recommended to remove :

• Dentures and mobile bridges to avoid their breakage during intubation maneuvers or their accidental ingestion
• Hearing aids
• Contact lens
• Rings, bracelets , watches, etc.

Make -up on the face and nail polish because they can prevent operators from carrying out a correct assessment of the oxygenation state of the tissues during the various phases of the operation.

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