Hospital-acquired infections - healthcare's ticking time bomb

Hospital-acquired or nosocomial infection is a major problem in many healthcare facilities with approximately 1 in 10 patients acquiring an infection during a hospital stay. These infections are the cause of much human misery for both patients and hospital staff, and are associated with high rates of morbidity and mortality. Furthermore, the economic impact of nosocomial infection on health care systems is alarming, eroding hospital budgets, profits and reputations. Urgent and innovative methods are needed to control the problem.

This is according to Technilamp, a leading supplier of ultraviolet germicidal irradiation (UVGI) technology which is currently been deployed as a 'must-have' preventive measure in pro-active health care facilities and TB clinics across the country and SADC region.

A huge concern

"A fact of huge concern for health care providers is that micro-organisms responsible for nosocomial infections are very difficult to eradicate and many have become drug resistant - notably infections such as methicillin resistant Staphylococcus aureus (MRSA), Acinetobacter spp and the multi-drug resistant Tuberculosis. Infections are spread in two ways, namely contact and inhalation, however conventional preventative methodology has been surface cleaning and hand washing. Currently remedial programs are seriously lacking in reducing the risks from the inhalation of airborne micro-organisms," explains Hylton Cowie, commercial director of Technilamp.

"Addressing the issue of airborne pathogens must be a high priority for healthcare institutions if we are to avoid a potential pandemic situation in our hospitals and clinics.

"Although most nosocomial infections are generally associated with person-to-person contact, there is increasing scientific evidence that many nosocomial infections are being transmitted via the airborne route. Estimates that the airborne route of transmission accounts for 10% of all sporadic cases of nosocomial infection are seriously underestimated.

"It is now recognised that a number of nosocomial pathogens, including Aspergillus, Acinetobacter and MRSA which are major problems in many hospitals throughout the world, can be transmitted by the airborne route. And of course TB, where the airborne route of infection has long been recognised, is a massive problem in health care facilities in southern Africa, particularly serving poorer communities and specifically in the case of immune-compromised patients," warns Hylton.

TB - the airborne danger

"Tuberculosis is transmitted by the airborne route caused by inhalation of infected air-borne droplets produced by infected individuals while coughing and sneezing. Transmission of TB occurs in situations where infected persons come into close contact with others, such as in hospital and clinic environments, overcrowded living quarters such as in mine hostels, shelters and so on. TB is a very real danger for both patients and medical workers and the risks of infection are rapidly mounting. Managing and reducing infection rates in clinics and hospitals and reducing the very real danger of infection for patients and medical staff is a healthcare emergency," explains Hylton.

Exacerbating the problem in southern Africa is the fact that TB acts synergistically with HIV and increases the risk of primary TB infection developing into the active disease by a hundred fold. The seriousness of the situation is compounded by the emergence of new multiple-drug resistant strains of MTB (MDR-TB) with case fatality rates of up to 93% being recorded with MDR-TB. The ever present potential for transmission of MDR-TB in the nosocomial setting is very serious.

UVGI is an effective and affordable antidote

Internationally, Ultraviolet germicidal irradiation (UVGI) is a proven and cost-effective means of killing off viruses and bacteria and more and more healthcare institutions are investing in the UVGI systems as a means of dramatically reducing the spread of communicable diseases, especially TB," explains Hylton.

In a study by Dr Edward Nardel of the Harvard Medical School comparing the efficacy of fans, filters or rays in the fight against TB, he noted that health care workers live in the corridors of hospitals, which are also important conduits of air and patients. The study concluded that the only technology inexpensive and potentially effective enough to be considered for the purpose of disinfecting air in corridors, waiting areas and emergency rooms, as well as isolation rooms is ultraviolet germicidal irradiation.

"Medical professionals have used ultraviolet irradiation in operating theatres and general wards around the world since 1937. Clinical tests conducted in general wards proved that the overall infection rates declined by more than 78% with the introduction of ultraviolet germicidal irradiation (UVGI).

These tests are in accordance with a study recently published which stated that ultraviolet lights could reduce the spread of TB in hospitals and waiting rooms by up to 70%," concludes Hylton.

For more information contact Technilamp on +27 (0) 11 839 1837 or go to www.technilamp.co.za

Reference: The use of engineering measures to control airborne pathogens in hospital buildings, Dr Clive Beggs, School of Civil Engineering, University of Leeds, Leeds LS2 9JT, UK.