Hospital Acquired Infection

THE CONVENTIONAL SYSTEM

“Hospital associated infections are a public concern. It is estimated that there are 200,000 healthcare associated infections in our hospitals each year in Australia. They cause patients pain, suffering and some patients die as a result”2 Health care associated infections in England are estimated to cost £1 billion a year. In the United States, the estimate is between US$4.5 billion & US$5.7 billion per year.3

• Hospital-acquired infections (HAI’s) are acquired either directly or indirectly in a healthcare facility. The infecting agent sources may be patients, staff or visitors and may include, the person’s own endogenous flora, persons who are colonised or chronic carriers of the infecting agent, persons with acute diseases or inanimate objects including equipment.

• Enterococci are now among the four most common nosocomial bacterial pathogens in the USA. They are a very hardy organism and can survive in the environment and on hands of hospital personnel...⁴

• Most gram-positive bacteria, such as Enterococcus spp. (including VRE), staphylococcus aureus (including MRSA), or stepptococcus pyogenes, survive for months on dry surfaces.⁵

• C difficile is shed in faeces. Any surface, device, or material (e.g. commodes, bathing tubs, & electronic rectal thermometers) that becomes contaminated with faeces may serve as a reservoir for the Clostridium Difficile spores. Clostridium Difficile spores are transferred to patients mainly via the hands of healthcare personnel who have touched a contaminated surface or item.⁶

THE SANIWASTE SYSTEM

The currently accepted thermal decontamination parameters for all bedpan Washer disinfectors (ie, 80˚C for 1 minute) are not adequate to eliminate C. difficile spores from bedpans.8 Sampling in hospitals has found VRE in most parts of the environment. Outbreaks have been attributed to contamination from rectal thermometers, bedpans and hospital beds.4

• ...surfaces with which hands come in contact are often contaminated with nosocomial pathogens, and may serve as vectors for cross-contamination.⁹  

• ...inanimate objects and the hospital environment can become contaminated with dangerous pathogens, and these organisms can persist for long periods if not eradicated.⁹

• Clostridium difficile-associated disease (CDAD) can range from uncomplicated diarrhea to sepsis and even death. CDAD rates and severity are increasing, possibly due to a new strain. Transmission of C difficile occurs primarily in health care facilities via the faecal-oral route following transient contamination of the hands of health care workers and patients; contamination of the patient care environment also plays an important role.¹⁰