WHO:Save lives: Clean your hands
4 May 2012 New Delhi: The World Health
Organization today raised an alarm about the large number of
healthcare-associated infections (HCAI) acquired during medical or
surgical procedures. These infections can result in prolonged hospital
stay, long-term disability, increased resistance to antibiotics and
sometimes, death. They substantially increase the financial burden on
the patient and health systems. HCAI can be prevented and the burden
reduced by as much as 50% or more through good hand hygiene. On 5 May,
WHO’s initiative, “Save lives: Clean Your Hands”, will focus on the
importance of hand hygiene in hospitals and health care facilities to
reduce healthcare-associated infections.
“There is clear evidence that hundreds of millions of patients are
infected every year worldwide by healthcare-associated infections. Low
and middle-income countries bear a huge burden of these infections” said
Dr. Samlee Plianbangchang, WHO Regional Director for South-East Asia.
“There is an urgent need to establish reliable systems for surveillance
of such infections to assess the actual burden. This must be treated as a
priority patient safety issue” he added.
The risk of HCAI is universal and pervades most healthcare
facilities worldwide, but the true burden remains unknown particularly
in developing countries. Risk factors for HCAI vary according to the
type of healthcare facility and to the care area where the patient is
admitted. The most common factors associated with HCAI are: patients
aged over 65 years; admission as an emergency and to the intensive care
unit (ICU); hospital stay longer than seven days; placement of a central
venous catheter, indwelling urinary catheter, or an endotracheal tube
and undergoing surgery. Low and middle-income countries bear an
additional burden due to poverty, lack of basic hygiene, limited
resources, malnutrition, patient age under 1 year and low birth weight.
General barriers to infection control practices are lack of financial
support, inadequate numbers of trained personnel working in infection
control, understaffed hospital units, and insufficient equipment and
supplies.
Surgical site infection (SSI) is the most surveyed and most
frequent type of infection in low and middle-income countries with
incidence rates ranging from 1.2 to 23.6 per 100 surgical procedures.
By contrast, SSI rates vary between 1.2% and 5.2% in developed
countries.
The risk of acquiring HCAI is significantly higher in intensive
care units (ICUs). The incidence of ICU-acquired infection among adult
patients in low and middle-income countries ranged from 4.4% up to 88.9%
and averaged at 42.7 episodes per 1000 patient-days.
High frequency of infection is associated with the use of invasive
devices, in particular central-lines (CL), urinary catheters, and
ventilators. Newborns are also a high-risk population in developing
countries and neonatal infection rates are three to 20 times higher than
in industrialized countries.
Evaluation of the key determinants of HCAI is an important step to
identify strategies and measures for improvement. Recommendations by
national and international organizations need to be implemented and
accompanied by performance monitoring in countries in South-East Asia.
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