Research for infection protection
  • germs
  • Adenovirus
  • Aspergillus niger
  • Bovine virus diarrhea
  • Clostridium difficile
  • Candida albicans
  • Candida albicans
  • Coronavirus
  • Corynebacterium
  • Escherichia coli
  • Helicobacter pylori

Source: How research findings improve infection protection; in Berlin on 09 February 2012; with Prof. Dr. med. Petra Gastmeier, Director, Institute for Hygiene and Environmental Medicine, Charité University Medicine Berlin, Germany; Prof. Dr. med. Günter Kampf; and Prof. Dr. rer. nat. Paul-Michael Kaulfers, Head of Hospital Hygiene, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.

EXPERT TALK

Challenges and opportunities in managing hospital-acquired infections.

What are the main challenges in hospital hygiene and what are the major trends in infection protection? An expert panel discussion – held at BODE SCIENCE CENTER’s lunchtime symposium “Hospital-acquired infection and hand hygiene: how research findings improve infection protection” in Berlin on 09 February 2012 – with Prof. Dr. med. Petra Gastmeier, Director, Institute for Hygiene and Environmental Medicine, Charité University Medicine Berlin, Germany; Dr. med. Günter Kampf, Director SCIENCE, BODE SCIENCE CENTER, Hamburg, Germany; and Prof. Dr. rer. nat. Paul-Michael Kaulfers, Head of Hospital Hygiene, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.


500 000 nosocomial infections per year – which patient group is at highest risk? 

Prof. Dr. med. Petra Gastmeier: The development of hospital-acquired infections depends on many factors, e.g. the patient’s immune status, type of procedure, and virulence of the pathogen. Major risk factors for all types of nosocomial infection are device-related diagnosis and therapy, e.g. catheters, ventilation or dialysis, as they offer pathogens artificial portals of entry.


What are the greatest challenges in combating nosocomial infections?

Prof. Dr. med. Petra Gastmeier: One problem is the demographically induced, anticipated increase in invasive procedures that will further enhance the risk of hospital-acquired infection. Additionally, pathogens are likely to show increasing resistance to multiple drugs – particularly Gram-negative bacteria for which the spectrum of effective antibiotics is very limited. 

Prof. Dr. rer. nat. Paul-Michael Kaulfers: We can confirm this observation in our clinic: The MRSA incidence has remained relatively stable, while the number of resistant Gram-negative pathogens with Extended-Spectrum Beta-Lactamases (ESBLs) is on the rise. Escherichia coli and Klebsiella pneumoniae are typical examples. Another problem is the occurrence of nonfermenters such as Pseudomonal and Acinetobacter species that exhibit resistance to Carbapenems, which are considered as reserve agents. The treatment possibilities are greatly limited here.


How does Germany compare to other European countries? 


Prof. Dr. med. Petra Gastmeier: This depends on the type of infection. For infections associated with hip prostheses, which belong to the most frequent procedures in Germany, we have, together with Finland, France and the UK, the lowest rate of nosocomial infection in comparison with 12 European countries. For the number of isolated antibiotic-resistant pathogens, Germany ranks in the mid-range with average rates between 10 and 25 per cent. For example, one third of the countries have MRSA rates over 25 per cent.


Hand disinfection is capable of effectively preventing the transmission of pathogens. There is a new standard?

Prof. Dr. med. Günter Kampf: Since the end of last year, the German „Aktion Saubere Hände” (Clean Hands Campaign) has recommended the responsible application for hand disinfection. This rub-in technique derives from our study, which revealed that the six-step method following the European test method EN 1500 leads to significant gaps in coverage. Compared to this method, which had been recommended for decades, the responsible application of hand disinfectants scored significantly better.


What does this new standard mean for the clinical practice?

Prof. Dr. med. Günter Kampf: Insufficiently disinfected hand areas may pose a risk of infection. In clinical practice, the new responsible application standard therefore offers increased patient safety. The user no more needs to follow any complicated instructions, which makes hand disinfection easier and better. 


Is there one specific key to preventing hospital-acquired infection?

Prof. Dr. med. Petra Gastmeier: 
Nosocomial infections may only be combated by multimodal strategies that in addition to involving hand hygiene campaigns such as the “Aktion Saubere Hände” assure appropriate nurse-to-patient ratios, which have a great impact on nosocomial infection rates. Furthermore, hygiene needs to be integrated into education and training more strongly.