Hospital-acquired infections are a serious issue in developed and developing countries. They kill about 37,000 people each year in the EU alone
When a huge number of patients and hospital staff congregate under the same roof, the risk of acquiring new infections from each other multiplies. According to a World Health Organization study, an average of 8.7 per cent of all hospital patients suffer from hospital-acquired infections (HAI), also known as nosocomial infections. At any given time, over 1.4 million people worldwide are grappling with the consequences of infections acquired in healthcare facilities.
HAIs are a serious issue in both developed and developing countries. They kill about 37,000 people each year in the EU alone, extracting seven billion euros from its economy. HAIs are also a leading cause of preventable deaths in the US, with 205 Americans dying every day due to them. While there are no Government statistics about the number of patients who contract HAIs in India, experts put the figure between 10 to 30 per cent, with some estimates suggesting it to be as high as 50 per cent.
The most frequent HAIs, in order of prevalence, are catheter-associated urinary tract infections, surgical wound infections, bloodstream infections and lower respiratory tract infections such as pneumonia. They are a significant cause of morbidity and mortality among hospitalised patients, leading to functional disability, emotional stress, serious health consequences, longer hospital stays and higher hospitalisation costs. Antibiotic-resistant hospital infections can be especially deadly.
HAIs can be acquired wherever healthcare is delivered. Patients with increased susceptibility or those whose treatment involves catheters or injections, are particularly at risk. A large proportion of these infections occur in intensive care units and surgical and orthopedic wards. The most common transmission route is indirect contact between patients through various objects, surfaces and medical instruments as well as the hands of healthcare workers who come in regular contact with patients.
A large proportion of HAIs is easily preventable by treating infection control as a priority and adopting simple hygiene. Unfortunately, a large number of hospitals in India do not follow safe practices, leading to spread of disease. Simple hygiene techniques like frequent hand washing, hand disinfection after surgical intervention, and use of gloves and gowns are primary preventive measures as healthcare workers are frequent transmitters of HAIs.
Injections are a major risk factor for HAIs. Safe injection practices are necessary for cutting off an important route of transmission. According to an International Clinical Epidemiology Network study on injection safety, about 62 per cent of the estimated six billion or so injections administered in India every year are unsafe. This poses a grave health risk to the patients, especially in the rural areas, and contributes to the rising disease burden. In fact, about three lakh people die in India every year due to infections caused by unsafe injections.
Vaccination practices in India are in urgent need of reforms. The country needs a law to make single-use, auto-disable syringes mandatory in healthcare settings as a way to prevent their reuse. Safe injection practices have to be built into the national health policy. The Government needs to train healthcare workers in safe injection practices, increase awareness among patients about health risks that non-sterile injections pose, provide adequate number of injections for various health programmes, and subsidise the use of auto-disable injections. Identifying and minimising the incidence of HAIs is the key to improving patient care in India. Controlling HAIs makes sense for hospitals too, with recent court judgements in India holding them responsible for HAIs and awarding hefty compensation to the patients.