Posts - Hygiene in the hospital

Deadly hospital germs: Hygiene deficiency is the new Ärztepfusch

According to statistics, the number of unnecessary deaths in the German health system has risen by around 37 percent. The increase is mainly due to serious hygiene deficiencies in clinics and medical practices. The measures to protect against pathogens are far from sufficient.

Photo AP

Operation in the clinic: Hygiene is the top priority

It is not due to surgical instruments that have been increasingly forgotten during an operation in the patient's stomach. It is also not due to more common gross misjudgment by doctors during treatment. So why did the number of Germans who died as a result of medical treatment increase from 1189 in 2009 to 1634 in 2010, or around 37 percent?

Correct evaluation of the data shows that it is not the surge of physicians but a very different factor that is responsible for the dramatic increase, namely "inadequate aseptic caution" or, more simply, a lack of hygiene. This was confirmed by an expert of the Federal Statistical Office SPIEGEL ONLINE.

"Kautelen describes all the measures that I perform on the patient," says Frauke Mattner, spokeswoman for the Hospital Hygiene Group of the German Hygiene Society. "Disinfect hands before taking a syringe, taking blood, or putting an injection." Same requirements apply to the execution of each therapy - up to operations. If errors are detected in retrospect, this ends up in the log, neatly giving it a number.

Every treatment in a clinic, every death is documented precisely - this is used to pay the hospital with the health insurance. The Aqua Institute, which is to control the quality in the German health system, also collects and analyzes the data. The Federal Statistical Office does the same. All use the same international coding key awarded by the World Health Organization. The number for the lack of hygiene in the treatment is the Y62.

The large increase in the number of deaths from hygiene problems is probably due to a more detailed documentation - in 2007, there was a revision of the gigantic numbering. This also explains the increase in reported numbers from five cases in 2007 to 434 in 2010.

The hygiene problem is known. In German hospitals, but also in nursing homes, rehabilitation centers and dialysis centers, there are plenty of so-called multidrug-resistant bacteria on the move, which tolerate almost all antibiotics. Every day, estimates the Robert Koch Institute (RKI), in Germany at least four people unnecessarily die from a hospital infection.

The infection control law passed in 2011, with which the Federal Government intends to stop development, is far from reaching patient associations far enough. There are estimates that up to 17,000 people per year die as a result of introduced germs. "It is unbelievable how the actual scandal is covered up with the now announced numbers," says Ilona Köster-Steinebach of the Association of Consumer Organizations (VZBV).

The VZBV criticizes the current Hygiene Protection Act that many of the rules that improve hygiene standards or require the employment of appropriately trained hospital staff are subject to long transitional periods. In addition, they are hardly controllable for patients and exempted from the respective federal states in the implementation. Uniform rules were missing.

In fact, quality assurance is also subject to analysis that could detect errors in the system. The Aqua Institute continuously monitors a total of 30 medical treatment groups based on ICD keys - for example, liver transplants or the use of cardiac pacemakers. The hygiene problem number Y62 is the quality guards not yet known.

UV-C - light treatment is especially effective against:

SARS, Corona viruses, H7N9 (also known by the term "bird flu") and also EBOLA.

What are hospital germs?

The term "hospital germs" summarizes bacterial strains that have developed resistance to antibiotics, often causing life-threatening illnesses.

MRSA

... (Methicillin-resistant Staphylococcus aureus) The bacteria can cause abscesses, boils, urinary or respiratory infections.

Enterobacteria

... can cause intestinal infections, urinary tract infections, inflammation of the lung tissue, in severe cases, blood poisoning.

Pseudomonas aeruginosa

... Bacteria can cause purulent pneumonia, urinary tract infections, meningitis, wound infections, intestinal inflammation and blood poisoning.

Acinetobacter bacteria

... can cause respiratory infections, blood poisoning and meningitis.

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Yasmin (4) died of hospital germs

(31.03.2019 - 12:48, Bild +)

Yasmin was only four years old, she died of Staphylococcus aureus, the so-called hospital germ.

Yasmin († 4) had a hard time from the start: she was born eight weeks early and suffered from epilepsy. After a seizure in September 2014, she had to spend a week in the intensive care unit of the Children and Adolescent Clinic of the University Hospital Rostock, receiving infusions and new medication. Although she had a fever, she was released. Since she probably already carried the germ, supposes Yasmins mother Maria.

Photo: Bild on Sunday / Jens Scholz

Maria Krause (28) with Yasmin's favorite cuddly toy: "She was born as a premature baby and was as big as the Fabric sheep at birth.

At home, Yasmine's temperature rose to over 40 degrees. The parents took her back to the emergency room. A doctor looked briefly in the child's throat and ears, suspected a cold. The life-threatening infection did not recognize the doctor. She prescribed an antipyretic instead of antibiotics and sent the family home at two o'clock at night.

Yasmin seemed a little better. But that was wrong. "Four days later, I wanted to dress her in the morning, when she suddenly had blisters on her face," the mother recalls. She raced to the clinic for the third time.

For 67 days Yasmin fought for her life. She was even transferred by helicopter to the Berlin Charité. "She was so tormented," says the mother. The bacteria had already spread in her body. Even blood transfusions could not save Yasmin. When the germ also settled on the heart valves, it was over. The life support machines were shut down on 11th November.

Four years after the death of her child, the parents now sue the clinic. Because according to the health insurance Yasmin could still live if the treating doctor had made a blood count and not sent the child home despite high fever.

Maria Krause is not concerned with her complaint for compensation. "We want to spare other parents this horror. The whole patient system does not skin - not only in this clinic, "says the mother. "The doctors are overworked, the cleaning staff had just two minutes per room." The customer review has been automatically translated from German.

Maria Krause still lacks the strength to go to Yasmine's grave alone. But in court she wants to be strong and fight. The death of their little ones should not have been in vain.

So dangerous are clinic germs

Across Europe, around 33,000 people die each year from multidrug-resistant germs.

When Maria Krause wants to be close to her daughter Yasmin, she opens a white wooden box. Inside are Yasmine's first romper and her pink children's glasses. Sometimes it seems to the mother as if her little girl had just taken her clumsily from the nose: "There are their fingerprints on it." But Yasmin is dead.

The girl from Rostock was only four years old, she died of Staphylococcus aureus , the so-called hospital germ .

She had a hard time from the start. Yasmin was born eight weeks early and suffered from epilepsy. After a seizure in September 2014, she had to spend a week in the intensive care unit of the Children and Adolescent Clinic of the University Hospital Rostock, receiving infusions and new medication. Although she had a fever, she was released. Since she probably already carried the germ, suspects the mother.

UV light kills dangerous hospital germs

Published on 18.10.2012 By Ilka Lehnen-Beyel

Again and again, numerous patients are infected with dangerous hospital germs

A simple method, which has been used for years in laboratories for disinfection, also proves itself in hospital rooms: Simple UV lamps drastically reduce the number of resistant germs.

Simple UV lamps could be used in the future to curb the spread of hospital germs. Placing them strategically in the middle of a hospital room, the high-energy radiation from the lamps kills most of the bacteria that accumulate on bedsteads, telephone handsets, and similar surfaces by being touched frequently. This suggests a study by American infectiologists.

The decisive factor, however, is that the lamps emit short-wave UV-C radiation, the team emphasized at a conference on hospital hygiene in San Diego, California. The method has been used for many years in laboratories and for the disinfection of air and liquids.

Focusing on Resistant Hospital Germs

Scientists led by Deverick Anderson of Duke University in Durham have focused their research on three very common hospital germs: Clostridium difficile, an intestinal bacterium that causes severe diarrhea in certain circumstances, the genus Acinetobacter, which is found in immunocompromised individuals both pneumonia and wound and urinary tract infections, and enterococci resistant to the antibiotic vancomycin (VRE). They can lead to severe infections in intensive care patients.

Altogether, the physicians selected 50 hospital rooms for their study, which previously had patients with at least one of these infections. Partly these were rooms in the intensive care unit, partly rooms on conventional wards. The researchers took samples of various surfaces in these rooms, including remote controls, the toilet and the handles on the bed.

They then placed a lamp in the middle of the room, with eight UV-C tubes attached to a central tube, and allowed the light to act for 45 minutes. Afterwards, they again took samples of the surfaces.

Drastic reduction of germ counts The number of viable germs on the surfaces decreased drastically as a result of the irradiation, as shown by the comparison of the samples. In Acinetobacter the burden fell by more than 98 percent, in the AER by 97.9 percent, as the scientists report.

The values in Clostridium had been similar, but there was the burden from the outset very low. Already in a previous study, a similar treatment showed that even the dreaded hospital germ MRSA could be combated with UV light, reported Anderson.

No staff and additional chemicals needed

The UV disinfection has the advantage that no staff is necessary and no additional chemicals should be used. Nor is it to be expected that the germs would become resistant to the treatment.

Medical room surfaces are usually treated with a liquid disinfectant, such as alcohol. In case of heavy contamination, a chemical such as formaldehyde can also be aerosolized to clean the entire room.

Those: www.welt.de/gesundheit/article110005142/UV-Licht-toetet-gefaehrliche-Krankenhauskeime.html

With blue light against bacteria

Tianhong Dai (Massachusetts General Hospital, Boston)
et al.: Antimicrobial Agents and Chemotherapy,
doi: 10.1128/AAC.01652-12 © wissenschaft.de
Ilka Lehnen-Beyel
29. Januar 2013

It seems almost too simple to be true: US researchers have discovered that simple blue light can kill bacteria in infected burns completely without damaging the injured skin. Even otherwise, the scientists could not observe a side effect of the treatment in mice. If the method is also proven in humans, there would finally be a new, gentle way to treat skin infections, even if they are caused by antibiotic-resistant bacteria.

Lighting up bacteria is not a completely new idea. There have already been tests with UV radiation of different wavelengths and different intensities, which should kill the microbes. Although this works, the high-energy radiation often causes severe damage to the treated areas of the skin. A potential alternative would be the so-called photodynamic therapy. She has been working in the clinic for a long time, for example against certain types of skin cancer or against vascular proliferations in the eye. In this case, the tissue to be treated is prepared before irradiation with a substance which decomposes through the light and thereby forms the actual active ingredient. He then kills the unwanted cells.

No additional active ingredient needed

In order to treat infections, the photosensitive material would have to be modified so that it only penetrates into the microbial cells and that is precisely what has not been achieved. In the case of burns, which are particularly frequent bacteria, it is also the fact that the skin itself is already extremely badly damaged and should not come into contact with chemicals. At this point, the blue light method comes into play: Although it uses the same principle as the photo-dynamics, but requires no additional photosensitive agent. Because the blue light disintegrates certain molecules that naturally occur in the interior of bacterial cells, but not in cells of mammals or humans. The principle has already been proven in studies of gingivitis and (?) In certain forms of acne.

The team led by dermatologist Michael Hamblin of Harvard Medical School now tested whether blue light can also do something about the generally more serious infections of burn victims. To do so, they first tested in the laboratory what effects irradiation with blue light had on cultivated skin cells and on bacteria of the Pseudomonas aeruginosa type. These microorganisms, which often cause skin infections, are particularly feared because they are often resistant to all common antibiotics. Result of the test: The bacteria lost their activity relatively quickly, whereas the skin cells did not show damage until much later. Optimal conditions for a blue light therapy against P. aeruginosa.

Resounding success

The researchers then tested their method in mice that had infected burns in the chest area with the bacteria. They irradiated the burned skin several times with a blue light-emitting diode and then observed how many bacteria were still alive and active. The results were extremely impressive, the team reports: While nine out of eleven died from untreated animals after less than three days of sepsis, not only do all the mice that were irradiated survive, their infections were virtually completely healed after this time. The treated skin also did not cause any damage, only a slight swelling had occurred shortly after the treatment, the team reports.

Despite the lack of data, the scientists assume that the method will prove to be just as effective in clinical trials as it is now in its trial. It is only necessary to check whether human skin survives the treatment as unscathed as the mouse skin, and whether over time can not resist resistance to radiation. The researchers themselves consider this unlikely, but can not completely rule it out. However, they see great potential in the method and suspect that it can also be used with other types of bacteria and infection types.

Those: www.wissenschaft.de/umwelt-natur/mit-blaulicht-gegen-bakterien-2/

Hospital germs:

40,000 deaths a year in German Hospitals

DGKH: Every year 40,000 deaths from hospital infections. - Halved case numbers, as they call the National Reference Center for Monitoring of Clinical Infections, are "in the spirit of the hospital lobby beautified and long outdated".

According to a newspaper report, in Germany twice as many people die of hospital infections a year as is generally known. That said the German society for hospital hygiene (DGKH) of the "West German general newspaper".

She speaks of one million patients who become infected with germs every year in clinics due to lack of hygiene - and of 40,000 deaths. Halved case numbers, as they call the National Reference Center for Monitoring of Clinical Infections, were "in the spirit of the hospital lobby beautified and long outdated," said DGKH Board Klaus-Dieter Zastrow the newspaper.

The DGKH unites Germany's most distinguished hospital hygienists. They say, "50 percent of all hospital infections are preventable." But hygiene is often managed "like a black box office: you cash in but do not do any hygiene." The 2011 tightened infection protection law contained "strict rules to be monitored by the country". But hospital operators are "not enthusiastic".

And their lobby is powerful, Zastrow said. Hygiene violations would have to be punished severely. "If the hospital manager knows that his chief surgeon does not care about hygiene, he has to fire him," Zastrow demanded. "The law gives that." Public health offices should "look" during checks. Then notice that in some clinics "everything is overridden".

Those: http://medtipp.com/index.php/allgemeines/1125-krankenhauskeime-40000-tote-jaehrlich-in-deutschen-hospitaelern

Hospital hygiene

Doctors rely on UV light

US doctors also want to use UV light to combat dangerous hospital germs. A test in clinical rooms shows that special lamps kill various common bacteria.

That UV light can kill bacteria is not new knowledge. However, in the face of increasing problems with antibiotic-resistant germs, this knowledge becomes valuable again. At a conference on hospital hygiene in San Diego, California, the IDWeek, physicians now reported how effective UV lamps can be in combating the germs.

The researchers led by Deverick Anderson at Duke University in Durham have specifically studied how the radiation affects three common hospital germs: Clostridium difficile, an intestinal bacterium that causes severe diarrhea in certain circumstances, the genus Acinetobacter, which causes both pneumonia and immunocompromised individuals can also cause wound and urinary tract infections, and enterococci resistant to the antibiotic vancomycin (AER). They can lead to severe infections in intensive care patients.

98 percent fewer viable germs

In all, the physicians selected 50 hospital rooms in which patients had previously been patients with at least one of these infections. Partly these were rooms in the intensive care unit, partly rooms on other wards. The researchers took samples of various surfaces in these rooms, including remote controls, the toilet and the handles on the bed. They then placed a lamp in the middle of the room, with eight UV-C bulbs attached to a central tube, and let the light in for 45 minutes. Afterwards, they again took samples of the surfaces.

The number of viable germs on the surfaces decreased drastically due to the irradiation - it sank by about 98 percent, as the scientists report. Already in a previous study, a similar treatment showed that even the dreaded hospital germ MRSA could be combated with UV light, reported Anderson.

"Of course, we would never suggest cleaning the rooms exclusively with UV light," Anderson pointed out. However, given the increasing number of bacteria that conventional antibiotics can no longer handle, the lamps could become an important additional method in the arsenal of hospitals. The UV disinfection has the advantage that no staff is necessary and no additional chemicals should be used. Nor is it to be expected that the germs would become resistant to the treatment.

It is crucial that the lamps emit the short-wave UV-C radiation, so the doctors. UV light has been used for many years in laboratories and for the disinfection of air and liquids.

Those: http://medtipp.com/index.php/allgemeines/1125-krankenhauskeime-40000-tote-jaehrlich-in-deutschen-hospitaelern

56 percent of Germans are afraid of hospital germs.

This resultedin a representative Emnid survey for BamS

By: TANJA TRESER AND SEBASTIAN PFEFFER

published on 04.02.2018 - 11:02

The most inked pants by Maik Mau (38) hang on a nail in the basement. For more than three years, the painter from Wetzlar (Hesse) can no longer pursue his job. He has captured a multidrug-resistant hospital germ.

"I deleted a garage," says Mau. He slips, twists his knee and tears the cruciate ligament. Three days after surgery, his knee gets thick and red. It hurts like hell. Doctors note: A hospital germ sits in the drill canal at the joint. In four operations they try to remove him. Vain. "My leg is unstable until today," says Mau.

Around 600,000 people annually become infected with germs that are resistant to almost all antibiotics. Around 20,000 of them die from episodes such as blood poisoning, urinary tract infection, gangrene or pneumonia. And the number of unreported cases is higher, says lawyer Burkhard Kirchhoff (49), who has been fighting for those affected for 20 years: "In Germany, we easily have one million infections a year." The death rate is also considerably higher.

"There are many multidrug-resistant bacteria in hospitals that are becoming more and more threatening. Also for people who come for a routine intervention, "says SPD health politician Karl Lauterbach (54). "Staying in a hospital has actually become a security risk."

As for the brother of television presenter Reinhold Beckmann (61). Wilhelm († 60) suffered from pulmonary fibrosis. His last chance: a transplant. The operation went well. But then his condition worsened. Reinhold Beckmann: "My brother got this germ on the first day, and of course his immune system was shut down after the lung transplantation." Wilhelm Beckmann died.

How to be infected with the pathogen is usually incomprehensible. Because the germs lurk everywhere: On catheters, the surgical cutlery, the doorknob, in the air conditioning and on the bedstead. About half of the infections could be avoided, experts such as Klaus-Dieter Zastrow (67), director of the Institute for Hygiene at the Rediomed-Kliniken Thüringen, say: "There is a lack of personnel and hygiene awareness. Also corresponding inspectors of health departments are missing on site or are too poorly trained. "

The multiresistant germ MRSA no longer responds to antibiotics Photo: picture alliance / BSIP

In order to equip the hospitals with the hygiene personnel required by law, the federal government has provided at least 460 million euros until 2019. However, many of the almost 2,000 clinics in Germany still have no hospital hygienists.

"The state has the monitoring function of compliance with the Infection Protection Act," says Zastrow. "He should do more, for example, with a duty to report death by hospital infections."

SPD health policy Lauterbach criticized: "There are many clinics lack of professionalism in dealing with hygiene. At least the big clinics must therefore be obliged to hire hygienists who are solely responsible for compliance with the hygiene rules." And patient advocate Kirchhoff says:" In Germany, French fries or slaughterhouses are more strictly controlled than some hospitals."

Ute Ott (59) report from Berlin. In a disc surgery in March 2011, she caught a MRSA germ. She suffers from the consequences today. Ott filed criminal charges against the senior physician, four doctors and sisters. Her charge: negligent assault. But the prosecutor stopped the proceedings.

Started: It was "not a current concern of the general public". The prosecutors admitted, however, "that earlier administration of a suitable antibiotic could have stopped the infection."

Ott is outraged: "How can the public prosecutor's office think the infection would not be a public interest, even though hundreds of thousands are infected every year with the germ and many do not survive?"

Other city, other prosecutor: In Wiesbaden (Hesse) was indicted two doctors of the Helios Hospital in Idstein raised for negligent bodily harm. The attending physician (58) is said to have removed a gall bladder from a patient in July 2011 and discharged her to the outpatient clinic despite signs of infection. The prosecutor accuses the chief physician of surgery (56) of not providing sufficient hygiene. The District Court is still investigating the indictment.

Ute Ott (59) became infected after an intervertebral disk operation Photo: Wolf Lux

So far, the shortcomings usually remained without consequences. For example, there is no case known to the Hessian State Examination and Investigation Office for 2017 in which a Hessian doctor should or was deprived of his license to practice medicine. Therefore, patient advocate Kirchhoff demands: "We urgently need a public prosecutor's office for hospital infections, which acts professionally against clinic management and doctors when there is hygiene in the bathroom."

At present clinics disguise the cases far too often, reports Institute Director Zastrow from his experience as a

consultant : "The clinics are trying to hide germ infections on a regular basis for fear of their reputation. I have seen cases where laboratory findings were cut and glued together with a few patients less. Three out of twelve germ-infested patients were made."

In 2016, the Medical Service of the health insurance companies prepared reports in 45 cases dealing with the consequences of hygiene deficiencies in hospitals. Result: Only four reports confirmed that the consequential damages were actually due to hospital germs. "The low number of treatment error reports and the confirmed errors on hygiene shortcomings do not approximate the dimension of the problem," says Max Skorning (41), Head of Patient Safety at the Medical Service of the GKV-Spitzenverband. "Treatment errors are rarely detectable," Skorning said. In fact, courts only assume compliance with hygiene standards if the requirements have actually been implemented. Means: The clinic must, for example, demonstrate that a hospital bed was properly cleaned.

Patient advocate Kirchhoff explains: "Every patient has a legally guaranteed claim to being placed in a clean and correctly prepared hospital bed. But not every hospital lives up to this claim. Unfortunately, we find out that there are clinics that need 15,000 beds per year, but can clean only 11,000 per year correctly."

Painter Mau also sued his doctors. The clinic offered him a comparison. He has a job for five months again. He puts plastic blanks in a machine. That brings him 800 euros less a month than his job as a painter. "Good thing I've got the right insurance," says Mau. "Otherwise I would have been broke for a long time."

When the hospital gets sick

Photo: Piekrasky

1. Admission

Most infections are transmitted through the hands. Resistant germs can also last for several days on objects and surfaces. In the recording many people meet each other. Since infection in otherwise healthy people is inconspicuous, they usually do not know that they are carriers.

2. Patients

If an infected patient without protective clothing is in the hospital, he can infect many other, weaker patients. That's why sufferers are usually isolated.

3. Station

room Tables, doorknobs, light switches, telephones - germs can be everywhere. Also in the bedding. Therefore, it must be treated separately and washed at least 60 degrees, otherwise germs can survive there for months.

4. Doctors

and Nurses If medical personnel do not change gloves, gowns and mouthguards immediately after contact with infected patients or are themselves carriers, contact with other patients or surfaces may lead to further infections.

5. Operating room

Although the risk of infection is significantly lower there than at the station, but also here it can come to infections. Especially by not sufficiently disinfected instruments -. As tube, contaminated disinfectant, infusion devices.