Hospital hygiene

The death on Tuesday of a third premature baby at a hospital in Mainz, after receiving a contaminated infusion, has reignited the debate about standards of hygiene in Germany's hospitals.

The baby was one of 11 who received a tainted drip feed on Friday and prosecutors have launched an investigation for possible charges of involuntary manslaughter and bodily harm.

Investigations were launched after intestinal bacteria was found by the hospital's microbiology center. Norbert Pfeiffer, chairman of the Mainz University Hospital board, said that it is not certain the contamination was directly to blame.

"The third child was born in the 24th week of pregnancy, and was very premature," Pfeiffer said. "Now we must work out what happened to ultimately cause the child's death."

Room for improvement

The story has rekindled concerns about the standards of hygiene in Germany's hospitals. Following fears of swine flu and superbugs such as MRSA and C-difficile, which are increasingly resistant to antibiotics, the cleanliness of hospitals and their staff has been under tight scrutiny.

Franz Sitzmann, a Berlin-based trainer of nurses who specialises in hospital hygiene told Deutsche Welle that standards "definitely can be improved."

"80 percent of hospital infections, even with the best hygiene standards cannot be avoided. However, the remaining 20 percent are the responsibility of the hospital workers and can be reduced," Sitzmann said.

Between 20,000 and 40,000 people die each year in Germany due to hospital infections.

Simple measures

The method for reducing hospital infections and the spread of bacteria is simple: staff need to wash their hands regularly.

"If I see people not washing their hands," said Sitzmann, "then I know there is a big risk of infection."

By using disinfectant hand wash before, between and after treating patients, doctors and nurses can stop the spread of potentially dangerous bacteria.

Dr. Alfred Nassauer from the Robert Koch Institute told Deutsche Welle that even when a hospital worker touches their face, they should wash their hands.

"We touch our face without knowing 80 times a day," said Nassauer. "My nose could be carrying cough and flu viruses, so of course I have to disinfect my hands."

He stated that hospital staff could be washing their hands 80 to 100 times a day.

Better education

Not only do hospital staff need to keep washing their hands, Dr. Nassauer argues they also need to understand why they are doing so.

"We have a big deficiency and need for good education in every single hospital," he said. "We need to teach about how bacteria and other pathogens are really transferred."

He said that even experienced doctors need to have their knowledge "refreshed every now and then."

Dr. Nassauer defended the current German hygiene regulations that have been published in a 400-plus page document. He told Deutsche Welle that although these good guidelines had been published, it was now a case of convincing people to implement them.

Resistance to antibiotics

Other measures that reduce the spread of infections include wearing, and disposing of rubber gloves and wearing the correct clothing.

Franz Sitzmann argues that another important measure is to reduce the amount of antibiotics being distributed.

"Antibiotics need to be better managed," he said. "We're using more and more and therefore seeing new, resistant strains of disease."

So-called superbugs such as MRSA and C-difficile were particularly hard for hospitals to deal with and treat, due to their resistance to antibiotics.

Hospital infections are particularly hazardous for the elderly, and as seen in Mainz, in the very young.

"Small children and newborns do not have a strong body defence system," said Sitzmann.

"Normally helpful micro organisms that live inside our body can cause us damage when we're sick," he added. "Those in hospital are by definition sick, and therefore more at risk to these microbes."

Author: Catherine Bolsover
Editor: Rob Turner