August 6, 2003

Hospital germs kill thousands, research finds
Inadequate infection-control measures result in 8,000 to 12,000 deaths each year

GLOBE AND MAIL


By ANDRÉ PICARD
PUBLIC HEALTH REPORTER
Wednesday, August 6, 2003 - Page A6


Fewer than one-quarter of Canadian hospitals have adequate measures in place to prevent patients and staff from acquiring potentially deadly infections, according to a new study.

As a result, as many as 12,000 people a year are dying from hospital-acquired infections, the researchers conclude.

"We are obviously not doing enough to make our hospitals safe," Dick Zoutman, the medical director of infection-control services at Kingston General Hospital and lead author of the study, said in an interview. "These are unacceptable numbers."

The study, published in today's edition of the American Journal of Infection Control, was conducted before the recent outbreak of severe acute respiratory syndrome, but Dr. Zoutman said "it certainly helps explain why hospitals were so hard hit by SARS."

To conduct the research, which was funded by Health Canada, researchers surveyed 172 hospitals with more than 80 acute-care beds to see whether they met minimum criteria for infection control.

Four basic measures were established by an expert committee after a landmark U.S. study on hospital-based infections.

In the new survey, the most comprehensive yet conducted in Canada, hospitals fared poorly in all aspects, including:

Having one full-time infection-control officer for every 250 beds. Only 40 per cent of Canadian hospitals meet that standard;

Employing a physician trained in infection control. Only 60 per cent of hospitals do so;

Conducting intensive surveillance of infections. The median score on an accepted index was 65 per cent, meaning many hospitals fail to keep watch for infections;

Carrying out intensive control when an infectious disease is transmitted in the hospital. The median score on an infection-control index was 60 per cent, meaning many hospitals fail to get bugs under control.

The researchers noted that only 37 per cent of Canadian hospitals notify surgical teams when an infectious agent is transmitted during surgery, suggesting that unsafe practices are not corrected promptly, if at all.

The study also noted that many infection-control programs lack rudimentary tools. For example, one-third of hospitals tabulate their infection data by hand, without the aid of computers.

Dr. Zoutman, a professor of medicine at Queen's University in Kingston, said what is most frustrating about the findings is knowing that proved measures are easy to implement and relatively inexpensive.

"Preventing infections is not difficult. It doesn't even require new technology. But it does require investment and commitment."

Dr. Zoutman said making hospitals safer would cost about $1,000 a year more per acute-care bed, or $250,000 for a 250-bed hospital. Treating a single case of a drug-resistant bacterium can easily cost that much.

"The payback is tremendous, not only financially, but in terms of the health of patients and staff."

An estimated 250,000 people annually contract infections in hospitals, and between 8,000 and 12,000 die as a result.

"The public should really be concerned about this. They should demand safer hospitals," Dr. Zoutman said.