The economics of preventing hospital acquired infections is most often described in general terms. The underlying concepts and mechanisms are rarely made explicit but should be understood for research and policy-making. We define the key economic concepts without using technical language and specify an illustrative model using hypothetical data to identify how two related questions might be addressed. These are (a) how much should be invested for infection control, and, (b) what are the most appropriate infection control programmes? We aim to make explicit the economics of preventing hospital acquired infections.

Economics and Preventing Hospital-Acquired Infection

Transmission of healthcare-associated infections caused by antibiotic- and multi-drug resistant (MDR) pathogens (e.g. Methicillin-resistant Staphylococcus aureus (MRSA), Pseudomonas aeruginosa) are a major concern in patient care facilities. Disinfectant usage is critical to control and prevent pathogen transmission, yet the relationships among strain, disinfectant type, contact time, and concentration are not well-characterized. We hypothesized that there would be significant differences in disinfectant efficacy among clinically relevant strains under off-label disinfectant conditions, but there would be less no differences among at registered label use concentrations and contact times. The purpose of this study was to quantify the effect of disinfectant concentration and contact time on the bactericidal efficacy of clinically relevant strains of S. aureus and P. aeruginosa. Accelerated hydrogen peroxide (AHP), quaternary ammonium compounds (Quat), and sodium hypochlorite were tested at label and reduced contact times and concentrations against four MDR P. aeruginosa strains and four MRSA strains. Quantitative EPA method MB-25-02 was used to measure disinfectant efficacy reported as log10 reduction. Both off-label disinfectant concentrations and contact times significantly affected efficacy of all disinfectants tested. Bactericidal efficacy varied among MRSA and P. aeruginosa strains. The quantitative disinfectant efficacy method used highlights the inter-strain variability that exists within a bacterial species. It also underscores the need for a disinfectant validation method that takes these variances into account.

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Strain, disinfectant, concentration, and contact time quantitatively impact disinfectant efficacy.

Healthcare-associated infection (HAI) is a major but often neglected public health problem. Most attention to HAI prevention is given to high-risk invasive diagnostic and therapeutic healthcare tools, while the importance of less critical tools tends to be underestimated. This study was designed to assess the potential contributory role played by thermometers and blood pressure cuffs in HAI transmission in a Nigerian teaching hospital. Analysis of swabs from thermometers and blood pressure cuffs used in the teaching hospital was conducted using standard microbiological techniques.

The Potential for Transmission of Hospital-Acquired Infections by Non-critical Medical Devices: The Role of Thermometers and Blood Pressure Cuffs

To determine bacterial contaminants and their antimicrobial susceptibility patterns from medical equipment and inanimate surfaces. Of 130 swabs, 115 (88.5%) swabs were culture positive, of which contaminated medical equipment and inanimate surfaces account 70 (83.3%) and 45 (97.8%), respectively. All the swabs collected from sphygmomanometer, bedside table, computer and computer standing tables were 100% contaminated with bacteria. From the culture-positive swabs, a total of 171 bacterial isolates were identified, out of which 117 (68.4%) and 54 (31.6%) isolates were gram-positive and gram-negative, respectively. Most isolates (82%) were resistant to ampicillin and 13%, 8.6%, and 14% was observed in ciprofloxacin, gentamicin, and tetracycline respectively. Multi-drug resistant was observed in Escherichia coli (72.7%) and Staphylococcus aureus (58.7%).

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Bacterial contamination and antimicrobial susceptibility patterns of intensive care units medical equipment and inanimate surfaces at Ayder Comprehensive Specialized Hospital, Mekelle, Northern Ethiopia

Carol Davis

Papers

Blood pressure cuffs and pulse oximeter sensors: A potential source of cross-contamination