|
Nordic NewsÅke Möller |
Problems caused by microbial contamination increased in Sweden towards the end of 1998. Several hospitals had to shut their operating theatres down due to viral infections among staff and patients. A recent study has tried to quantify the number of cases of infection picked up by patients after admission to hospital. Legionella outbreaks continue to occur. It is surprising that, in this "High Tech" age, such hazards are not better controlled. It is now more than a century since the microbial nature of infections was clearly identified. Are we underestimating these minute enemies?
Pharmaceutical and Medical Device Manufacture have figured
largely in the Society membership from the beginning and this has given the
Society a special "flavour" but, peculiarly enough, the sector where
the greatest area of cleanrooms is to be found (see diagram) is represented
in the Society by very few members. In the early 1970s, some well known hospital
doctors were members of the Society Board but they seemed to look on contamination
control as mainly for engineers and drug manufacturers. A similar situation
appears to exist in the other 15 contamination control societies. There is no
reason why modern contamination control technology should not be of great value
to hospitals; on the contrary it could help to reduce contagious infections.
There must be a reason for this. In the author's experience, there is too little
co-operation between "rational" industrialists and medical experts.
This contrasts with the positive news that the large Food Technology sector
is increasingly realising the value of contamination control technology.
An outbreak of Norwalk virus infections began in southern Sweden in mid-November and, by early December, six hospitals had more than 300 people, mostly staff, infected. Surgery and any intake of new patients was stopped at all of them. These infections can spread very quickly with serious consequences for patients and staff.
A well known Swedish hospital hygienist, Dr Bertil Nyström (who was one of the early Board members of R3-NORDIC) presented in November 1998, at the Annual Conference of Swedish Physicians, a survey of nosocomial problems. According to him, 800 people die every year in Sweden due to infections that they contract during treatment. He estimates that approximately 100,000 are infected every year by some kind of hospital disease. The direct costs are assumed to be equivalent to £1,300 million annually. Dr Nyström suggests a doubling of the number of hygiene doctors and nurses and the Government has been asked for fast action and for a national register to record frequent reports of the nosocomial status of individual hospitals.
The tragic deaths by fire of 80 young people at a disco in Gothenburg in November has drawn attention to the fact that fire victims are particularly susceptible to septicaemia and pneumonia (and pneumonia is fairly common in hospitals).
In September, there was a two-day international conference in Copenhagen on the growing problem of multiresistant bacteria. Several hundred participated and they decided to press for a monitoring system, co-ordinated by the European Union. Better education is also needed to reduce the excessive use of antibiotics. Over the last three years, there has been a gradual reduction in the Nordic countries.
The modern world is complex. The European farming industry uses antibiotics to improve animal growth and the meat can therefore contain antibiotic residues and also multiresistant bacteria. Birds such as gulls like to feed on dumps, wastes from slaughterhouses, etc. In 1997, it was found in a summer study in northern Sweden that 4 per cent of seabirds carry antibiotic-resistant Salmonella bacteria. The study was repeated this summer and new species of resistant Salmonella were detected. The transfer chain to humans can be through bird faeces spread on grass where cows graze, resulting in resistant Salmonella in the stomach and then in the meat.
There are many reasons to reduce the use of antibiotics in animal feeding, especially since much of it is simply to increase profits.
