Report: Millions Infected in Europe's Hospitals

More than 3 million patients a year acquire some sort of infection in Europe's hospitals, a new report says. On any given day, about 1 out of 18 patients has such an infection, according to the report. The European Centre for Diseases Prevention and Control (ECDC) published the study. It was based on a survey of 1,000 hospitals. Intensive-care units had the highest rates of hospital-acquired infection. About 20% of ICU patients were affected. Infections of the lungs and bloodstream were the most common. There were also many infections of the urinary tract and at the site of surgery. Many infections were drug-resistant. That includes 40% of all infections caused by Staphylococcus aureus bacteria. This type of Staph infection is often called MRSA. The ECDC urged hospitals to strengthen infection-control programs. Reuters Health news service wrote about the report.

By Howard LeWine, M.D.
Harvard Medical School

What Is the Doctor's Reaction?

Hospitals have lots of rules to prevent the spread of bacteria between patients. These efforts are very costly, but necessary. They surely have helped some. But no one would call what is routine practice in most hospitals a success.

Here are some of the basics that most hospitals do in developed countries:

• Patients are routinely screened to see if they are colonized with certain types of bacteria. Being colonized means the person carries the bug on the skin or inside the nose. But he or she does not have any symptoms related to the bacteria. An infection implies there are symptoms, such as fever, chills, cough or problems with urinating.
• Patients known to be infected or colonized with certain types of bacteria are placed in isolation rooms. These bacteria include the ones that spread easily from patients to staff and back to patients. They also include the bacteria that are very difficult to treat, so-called antibiotic-resistant bacteria.
• All staff going into an isolation room must take certain precautions. These are listed on a sign outside the door. They differ depending on the type of bacteria. Of course, the precautions include cleansing hands before and after entering the room. Staff also must wear gowns and gloves that they throw away after the visit. If there is concern about influenza or other airborne germs, staff put on masks.

Despite these efforts, hospitals remain unsafe environments. A major reason is the rising number of bacterial infections that don't respond to the usual antibiotics. Even with more and more attention to avoiding spread, the antibiotic-resistant germs keep finding ways to get stronger.

In part, the rise in drug resistance is a credit to advances in medicine that allow people with long-term diseases to live longer. These are the patients who fill so many hospital beds today. They typically have impaired immune systems. Their bodies can't stop germs from taking hold once they are exposed.

What Changes Can I Make Now?

If you are in the hospital, or a loved one is, insist that hospital staff wash their hands. Hand washing with soap and water is one of the best ways to stop the spread of germs.

If you visit a hospital or other health-care facility, practice careful hand hygiene yourself. It is best to wash your hands thoroughly with soap and water for at least 15 to 20 seconds as soon as possible after your visit. Alcohol-based hand cleansers don't kill some types of bacteria.

Sometimes you need to be in the hospital. But as soon as you feel well enough, find out if home health care is an option for you. You want to be discharged as soon as it is safe. A longer hospital stay increases your risk of developing a hospital-related infection.

A longer hospital stay also increases the chance of forming a blood clot in your leg. And each extra day in the hospital causes you to lose some of your strength and stamina. Your muscles start to weaken. You also tend not to breathe as deeply. These factors increase your risk of developing hospital-acquired pneumonia.

What Can I Expect Looking to the Future?

It would be terrific if we could find a single way to greatly improve the current rate of hospital-acquired infections. But that is very unlikely. So it will take even greater efforts to strictly follow existing hospital practices. The other important thing we must do is to cut back on excess use of antibiotics. Using these drugs when they are not needed makes surviving bacteria stronger and more resistant to treatment.