Alarming news about nosocomial—hospital acquired—infections have unsettled all participants in the healthcare system, met with enormous interest among the public, and triggered substantial countermeasures. Comprehensive disinfection and early administration of antibiotics serve as the generalized response to the problem, although it is especially these that have equally been considered as its cause. Screening all hospital patients for pathogens posing a special risk contributes further to the explosion of the associated costs.
Questions regarding hygiene have in recent years also included quality management in doctors’ practices. Disinfection measures for door handles, exercise bikes, and ultrasound equipment have been recommended, although no scientific basis exists for this whatsoever. Except for special cases, the wearing of surgical gloves when performing phlebotomy in the surgery also ranks among the controversial measures. In addition to the enormous costs owing to the seeming prophylaxis, allergies and skin problems when wearing gloves, comprehensive disinfection resulting in selection of pathogens, and antibiotic resistance are among the problems of the future (1–3).
I have run my private practice for cardiopulmonary medicine for 15 years now, and not a single case of “nosocomial” infection has occurred. This is in spite of the fact that we treat patients with sputum smear positive tuberculosis and tumors, as well as a large number of multimorbid patients. Fortunately, the occupational health physician responsible for the practice has left it to our own discretion whether we wish our staff members to wear gloves when performing phlebotomy or to undertake comprehensive disinfection of the practice equipment. The evidence on which recommendations considering the actual benefit of such hygiene standards are usually based seems rather scarce as far as doctors’ private practices are concerned.
Prof. Dr. med. Damian Franzen
|1.||Turner S, McNamee R, Agius R, Wilkinson SM, Carder M, Stockes SJ: Evaluating interventions aimed at reducing occupational exposure to latex and rubber glove allergens. Occup Environ Med 2012; 69: 925–31 CrossRef MEDLINE|
|2.||Carlet J, Jalier V, Harbarth S, Voss A, Goossens H, Pittet D: Ready for a world without antibiotics? The Pensières Antibiotic Resistance Call to Action. Antimicrob Resist Infect Control 2012; 1: 11 CrossRef MEDLINE PubMed Central|
|3.||Hsueh PR, Chen WH, Luh KT: Relationships between antimicrobial use and antimicrobial resistance in Gram-negative bacteria causing nosocomial infections from 1991–2003 at a university hospital in Taiwan. Int J Antimicrob Agents 2005; 26: 463–72 CrossRef MEDLINE|
|4.||Behnke M, Hansen S, Leistner R, et al.: Nosocomial infection and antibiotic use: A Second National Prevalence Study in Germany. Dtsch Arztebl Int 2013; 110(38): 627–33 VOLLTEXT|