Resistant germs: infection in the hospital

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Resistant germs: infection in the hospital.

(08/26/2010) After the deaths of the three infants in the Mainz University Clinic put the problem of germs in German hospitals back on the agenda, the black and yellow federal government now sees itself forced to act: New guidelines for hospital hygiene should come here.

According to the Allianz report "Sick in the hospital", up to one million patients are infected with dangerous germs in German hospitals every year, often with fatal consequences. The enormous increase in infections caused by multi-resistant staphylococci (MRSA) is an expression of poor hygiene.

But the push towards new guidelines for hospital hygiene is resolved by the Dutch microbiologist of the Medisch Spectrum in Twente and expert in hospital hygiene, Dr. Ron Hendrix, in an interview with the broadcaster ntv just laughed out loud. Because in his view the German guidelines are very good at this point, only their implementation leaves something to be desired.

In the Netherlands, infections from MRSA bacteria rarely occur in hospitals, although there are no comparable legal guidelines. Here, the hygiene rules are created individually by experts for each hospital and are essentially based on the practical requirements. For this reason, each hospital has its own microbiologist there, who advises the staff on hygiene issues and also ensures that the use of antibiotics is kept within limits. The relevant specialists are closely involved in the daily processes of patient treatment and communicate intensively with the various specialists. This approach is favored by the structure of the hospitals in the Netherlands, since small clinics that concentrate on one specialist area, as is often the case in Germany, are rather the exception. According to Dr. Hendrix regularly brings together specialists from a wide range of disciplines and advise each other. “It is normal for us that a microbiologist advises a doctor about infectious diseases and tells him whether an antibiotic should be used. A surgeon, for example, cannot be an expert in the field of antibiotics, ”the microbiologist and head of the Euregio network told ntv.

The massive or partly irrational use of antibiotics in German hospitals is from Dr. Hendrix also a problem. Because of the intensive advice given by the microbiologists, the doctors in the Netherlands manage with a fraction of the amount used in Germany. With the advantage that fewer bacteria develop resistance to antibiotics. “Only a few days ago, a bacterium was reported that no longer responds to today's antibiotics. That is why antibiotics are rarely prescribed in Holland - and if possible, old drugs such as penicillin, ”emphasized Dr. Hendrix. According to the specialist, this is another reason why infections with the wound germ MRSA occur about 20 times more frequently in German hospitals than in the Netherlands.

When asked what possible solutions to the hygiene problem in German hospitals, Dr. sees Hendrix only one way out: more money must be invested in hygiene professionals and microbiologists. The "German Society for Hospital Hygiene" (DGKH) is of a similar view and therefore wants to make the hiring of hygienic personnel in hospitals mandatory from the state side. The advantage of such investments would be that they would be "double and triple" in the course of the saved costs for the treatment of nosocomial infections (hospital infections), said the microbiologist Dr. Only five percent of German hospitals currently have a hygiene doctor.

Patients who are considered potential carriers of MRSA are tested for the pathogen in the Netherlands as soon as they arrive at the hospital. If the result of the test is positive, the patients come in single rooms and are only treated by nursing staff in protective clothing. The risk groups who must in any case have to undergo an MRSA test when admitted to the hospital include all those who have previously had MRSA carriers themselves or have had contact with them, who have recently been treated in hospital, who need chronic care or who require dialysis, or who suffer from chronically open wounds. In addition, all residents of retirement or nursing homes belong to the risk patients. Patients who are transferred from a German hospital to the Netherlands also belong to the risk group and are initially quarantined upon arrival, according to the Dutch microbiologist Dr. Hendrix, because "German doctors operate very well, but we are afraid of infections."

However, due to the different medical landscape, the Dutch system cannot simply be transferred to Germany, according to the expert who is also involved in the Euregio network, Alexander Friedrich from the Institute for Hygiene at the University of Münster, but "we rather have to adapt it." (Fp)

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The new super germ NDM-1

Image: Erich Werner /

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