GMS Krankenhaushygiene Interdisziplinär

The increasing number of people who are colonized or infected with multidrug-resistant bacteria imposes a high economic burden on society which includes the negative impact on health status as an intangible cost. An economic analysis leads to the conclusion that currently too little is done to prevent or control infections. The reasons include insufficient incentives for health care providers, a lack of reliable data on both the prevalence and the effects of infection, and a lack of coordination among the different branches of the health care sector...

The increased incidence of infections caused by methicillin-resistant strains of Staphylococcus aureus (MRSA) burdens the healthcare systems with significant additional costs. Simple measures such as active MRSA screening can lead to a reduction of infectious events and massive savings. To establish an effective and comprehensive strategy for prevention and eradication of MRSA, the cooperation and networking of all stakeholders in the health care system is necessary. Pharmaceutical companies are part of the health care system; they therefore have a vital and ethical interest that care within the health system will be further optimized and thus continue to remain affordable...

The basis for the management and documentation of multiresistant organisms (MRO) in medical facilities in Germany are the Infection Protection Act (IPA) and the recommendations given by the Commission for Hospital Hygiene and Infection Prevention at the Robert Koch Institute (KRINKO).With the Infection Protection Amendment Act an accounting capability for the treatment of patients with MRO will be established in the outpatient care sector. At the same time an electronic documentation is required. In order to comply with the law demanding that the transfer of data concerning the carrier status of a patient should be done without any delays or errors and with minimal effort...

OBJECTIVE: Data on the prevalence of emerging bacterial pathogens like extended-spectrum-lactamase-building (ESBL) Gram negative organisms, multiresistant Pseudomonas and Acinetobacter species or toxin-building Clostridium difficile in German hospitals are sparse. To provide data for different regions in Germany, a one-day point prevalence study with five tertiary care hospitals and four secondary care hospitals was conducted on the 10(th) of February 2010. METHOD: For participating hospitals, the level of care (primary/secondary/tertiary), staffing with infection prevention personnel, availability of a MRSA-screening, microbiological support and the prevalence of five emerging bacterial pathogens in intensive care, surgical and medical wards was assessed by questionnaire...

In the present study we have analyzed the impact of modified MRSA screening of carriers and patients on epidemiological situation of MRSA during 2008-2010, comparing two regional hospitals with similar bed numbers and similar ward profiles in Northern Poland. In 2008 the proportion of MRSA to all S. aureus isolates was 14.4% resp. 6.0%, in 2009 8.3% resp. 4.7% and in 2010 6.5% in both hospitals. Independent of the different prevention and intervention strategy in both hospitals the different MRSA incidence seems to be due to regional epidemic settings...

Health care associated infections, the fourth leading cause of disease in industrialised countries, are a major health issue. One part of this condition is based on the increasing insertion and implantation of prosthetic medical devices, since presence of a foreign body significantly reduces the number of bacteria required to produce infection. The most significant hospital-acquired infections, based on frequency and potential severity, are those related to procedures e.g. surgical site infections and medical devices, including urinary tract infection in catheterized patients, pneumonia in patients intubated on a ventilator and bacteraemia related to intravascular catheter use...

Septic loosening of total hip and knee endoprostheses gains an increasing proportion of revision arthroplasties. Operative revisions of infected endoprostheses are mentally and physically wearing for the patient, challenging for the surgeon and a significant economic burden for healthcare systems. In cases of early infection within the first three weeks after implantation a one-stage revision with leaving the implant in place is widely accepted. The recommendations for the management of late infections vary by far...

Within the first two years after total hip arthroplasty implant-associated infection has become the second most common reason for a revision surgery. Two-stage implant exchange is frequently conducted using temporary spacers made of antibiotic-loaded cement in order to prevent a bacterial colonization on the spacer. Avoiding several disadvantages of cement spacers, a conventional hemi-endoprosthesis was equipped with a copper-containing implant coating for inhibition of bacterial biofilms. In the present paper details of this novel treatment concept are presented including a case report...

AIM: To assess the safety and cost effectiveness of a usage for seven days of breathing circuit systems (BCSs) in combination with heat moisture exchanger filters (HMEF) in operation room anesthesia. METHOD: In a prospective longitudinal clinical study, the contamination on high-risk surfaces (HMEF together with inner and outer surface of BCS) was monitored over 1, 2, 5, and 7 days. RESULTS of endogenous respiratory patient flora and contamination flora of BCS, HMEF and bag were compared...

BACKGROUND: Bacterial contamination of anesthesia breathing machines and their potential hazard for pulmonary infection and cross-infection among anesthetized patients has been an infection control issue since the 1950s. Disposable equipment and bacterial filters have been introduced to minimize this risk. However, the machines' internal breathing-circuit-system has been considered to be free of micro-organisms without providing adequate data supporting this view. The aim of the study was to investigate if any micro-organisms can be yielded from used internal machines' breathing-circuit-system...

BACKGROUND: Prevention of post-endoscopy infections is an important objective to assure patient safety. Endowashers, or high throughput irrigation water pumps, are a frequently used device on endoscopes. Recommendations published by professional bodies and regulatory health agencies cover not only adequate reprocessing of fiber-endoscopes but also state accepted methods of regular microbial sampling. Although major instruments like endoscopes are covered by these recommendations, other devices used as optional add-ons for endoscopes are not included...

Current evidence does not favour constructional over functional separation of septic and aseptic surgical procedures in terms of overall hygiene maintenance and incidence of skin and soft tissue infections. In both laminar and turbulent flow air operating theatres, air is not a relevant source of pathogens if surface disinfection is carried out properly.Final cleaning after a septic procedure includes a thorough wipe-disinfection of all potentially contaminated near and distant surfaces, including maintaining the necessary and effective exposure time of the chosen surface disinfectant...

BACKGROUND: Construction and renovation work in hospitals pose risks of fungal airborne infections for immunosuppressed patients. If possible, reconstruction work will be postponed to periods without patient treatment. However, in many situations urgent damage demands immediate refurbishment works before the transferring of patients to other wards or closure of wards is possible. Reported here are infection control related measures and implemented procedures after two incidents of water damage which occurred on a surgical ward and an intensive care unit at the University hospital of Essen...

AIM: As door handles represent a transmission route for viruses and micro-organisms, a door opening and closing mechanism should be developed without manual operation. METHOD: To solve the problem, a device for opening the door with the help of a foot pedal was built into the door leaf. RESULTS: The design enables mechanical opening of the door with a foot pedal without manual operation. Subsequently, the door closes with the help of a mechanical locking mechanism...

AIM: In 2010, the ASP GLOSAIR(TM) 400 was introduced in Germany for nebulizing hydrogen peroxide (H(2)O(2)). Since there were no results of practical experience, the new method was to be checked under practical conditions for its effectiveness in decontaminating air in rooms, infested with mold after water damage and, at the same time, under experimentally controlled conditions, test surfaces, contaminated with Aspergillus brasiliensis. METHOD: After the nebulizer was used in two rooms with a massive mold infestation, the air colony count was determined (MAS-100(®) Zinsser Analytik) and, at the same time, the mold infestation in samples of wall plaster...

Dermatitis of hands is a problem among nurses. The aim of this prospective questionnaire based survey was to analyze practice and knowledge of skin care of medical and surgical nurses. 250 questionnaires were distributed. 49% of respondent stated that they perform skin care at least 1-2 times/day. After hand-wash 15% of participants perform skin protection, after hand-disinfection only 2%. 40% give skin care products less than 3 minutes to be applied. It was shown that this knowledge is lacking in many individuals, leading to wrong behavior at work and insufficient use of skin protection and skin care products...

BACKGROUND: In Germany, cost calculations on the financial burden of wound treatment are scarce. Studies for attributable costs in hospitalized patients estimate for pressure ulcer additional costs of € 6,135.50 per patient, a calculation based on the assumption that pressure ulcers will lead to prolonged hospitalization averaging 2 months. The scant data available in this field prompted us to conduct a prospective economical study assessing the direct costs of treatment of chronic ulcers in hospitalized patients...

BACKGROUND: An in-vitro study was conducted investigating the antimicrobial efficacy of polihexanide and triclosan against clinical isolates and reference laboratory strains of Staphylococcus aureus and Escherichia coli. METHODS: The minimal inhibitory concentration (MIC) and the minimal microbicidal concentration (MMC) were determined following DIN 58940-81 using a micro-dilution assay and a quantitative suspension test following EN 1040. Polihexanide was tested in polyethylene glycol 4000, triclosan in aqueous solutions...

A new technological approach for supplying hypoxic chronic wounds with oxygen is a moist wound treatment with aqueous solutions containing tissue compatible oxygen binders. This facilitates diffusion of oxygen, necessary for the healing process, from the surroundings (room air through an open-porous wound padding) into the ulcerous tissue. A product that is still in development is a spray which contains hemoglobin obtained from domestic pigs. Clinical investigations (a clinical trial, treatment observations and single patient uses) are presented, which were performed to create clinical data regarding efficiency and safety of this product...

BACKGROUND: It has been suggested that Mycoplasma pneumoniae may play a role in the development of atherosclerosis, but to date this association is still a matter of debate due to conflicting findings. METHODS: We have investigated the levels of specific IgA antibodies to M. pneumoniae in 91 patients with internal carotid artery (ICA) stenosis using a commercial kit (SeroMP™ IgA; Savyon Diagnostics, Israel; cut-off value: 20 binding units; BU). All patients underwent surgery for ICA stenosis...