Finnish hospitals deficient in personnel specialized in infection prevention

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A network of personnel specialized in the prevention of oubreaks of hospital infections is far from complete in Finland, being deficient both in infection physicians and hygienist-nurses.
      Last week Finns became alarmed by the emergence of a new form of intestinal bacteria, the Clostridium difficile ribotype 027, which causes a more severe form of antibiotic-associated diarrhoea.
     
The new strain of Clostridium difficile was recently detected in three patients in the province of Uusimaa, who all died from the disease.
      Since 2003, the Clostridium difficile ribotype 027 has caused epidemics in the United States and Canada (particularly in Quebec, giving rise to the variant also being known as the "Quebec Strain"), and since 2004 in some European countries as well. A major scandal broke in England over ths subject in October this year.
      Apart from the variant 027, an epidemic can also be caused by a number of other bacteria. For example the milder version of Clostridium difficile is the most common cause of diarrhoea related to the taking of antibiotics.
      Experts say that the most typical cases involve infections in hospitals and other treatment institutions, where the disease can spread from one patient to another.
     
The Finnish hospital districts have to fight against infections with scarce resources, notes Research Professor Petri Ruutu of the National Public Health Institute.
      In 2004, an amendment to the Communicable Diseases Act was was drafted mentioning hospital infections, which initiated the drawing up of a preparedness plan.
      The infection specialists of the central hospitals are also responsible for the overall guidance in the area’s hospitals and other institutions.
     
Last spring, the number of infection nurses was around 50 in each district, while that of infection physicians was just one or two. Only the Helsinki University Central Hospital has more than two infection doctors.
      Universally applicable studies indicate that the higher the number of personnel per patient, the lower the number of infections, says Ruutu.
      Understandably, if personnel are too busy it frequently means sacrificing hygiene.
     
Typically, hygiene is taken care of by using antiseptic hand sanitisers, which are also recommended for visitors. However, such sanitisers are not effective against certain bacteria, including the Clostridium difficile variant 027.
     
Under normal circumstances, an antiseptic hand sanitiser is sufficient, if a visitor is just sitting by the patient’s bed and talking. However, visitors who touch patients should also use soap and water, recommends hygienist-nurse Tuija Nurkkala from Kemi.
      In serious cases, individuals can be ordered into quarantine if they have been exposed to an infection.
      According to the National Public Health Institute, each hospital district should have two specialist infection doctors, in order that a specialist would be available even during holiday seasons.


Previously in HS International Edition:
  Intestinal bacteria blamed for three deaths in south of Finland (2.11.2007)

Links:
  National Public Health Institute
  Clostridium difficile (Wikipedia)

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