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REFERENCE
Letters to the editor
Global strategy for infection control in hospitals
To the Editor:
Lazzari et al 1 have meticulously addressed the prevailing
global scenario of the scourge of hospital infection.
Undoubtedly, the recommended HAI international strategy
of implementation of standardised procedures for
surveillance of health care establishment-acquired infection
would mitigate the associated morbidity and mortality.
While the national level government agency would be the
ideal nodal agency for promotion and implementation of
any efficient plan, non-government hospitals would be
important partners in an effective accomplishment of the
prospective action plans. Moreover, even rather alternative
surveillance for hospital infection might be a fairly effective
approach. A laboratory based surveillance for hospitalised
patients with a community acquired or nosocomial
infection has been operational in a private sector hospital in
the Indian capital metropolis.
An infection control team comprising a clinical
microbiologist, a gynecologist/obstetrician and two
microbiology technologists was charged with the
responsibility of surveillance of hospital infection at the Sant
Parmanand Hospital. Located in the northern part of the
Indian capital metropolis, the 140-bed tertiary care hospital
caters to ordinary people in the national capital and
adjoining townships. The team briefs the management
through the Hospital Director. Episodes of bacterial and
fungal infections among patients are picked up from
microbiology cultures on clinical material. Isolates from
patients within two to three days of hospital admission are
recorded as ‘community acquired’. On the contrary, any
isolate cultured after three days of hospitalisation is
reported as ‘nosocomial’. The culture reports and the
antibiotic susceptibility pattern are communicated to the
clinician responsible for the patient care and the nursing
personnel. Furthermore, there has been no secondary
spread of infection from patients. The team has close
association with clinicians and evaluates the hospital state
of affairs regularly.
During the past year, the rate of monthly nosocomial
infections per 100 admissions has varied from 0- 0.57 per
100 admissions (Table 1). There has been no administrative
hurdle as no additional budget was sought form the
management. The team members are well motivated and
clinicians receive details about any infected patient under
their charge punctually so that proper treatment can be
instituted.
Ward-based clinical surveillance has not been a
component of our programme. We plan to strengthen the
current surveillance for any missed episodes of hospital
acquired cases, both during hospitalisation and in the postdischarge
period. Undoubtedly, the future HAI strategy of
standardised procedures for surveillance of health care
establishment-acquired infection 1 would be of immense
Month
November 2003 0
December 2003 0.13
January 2004 0
February 2004 0.31
March 2004 0.12
April 2004 0.14
May 2004 0.43
June 2004 0.44
July 2004 0.57
August 2004 0.4
September 2004 0.39
October 2004 0.51
Nosocomial infections/
100 admissions
value to health care establishments with almost negligible
financial support from existing sources.
Last but not least, microbial-culture-based strategy would
be an effective weapon in reducing the incidence of
hospital-acquired infection. Even without a comprehensive
plan of ward-based surveillance in any hospital, that should
strengthen efforts to tackle the global scourge of hospital
infections. Such an infrastructure would be an asset to the
future international efforts to introduce hospital
surveillance protocols 1 .
ARYA, Subhash C.
AGARWAL, Nirmala
Sant Parmanand Hospital, 18 Alipore Road,
Delhi- 110054, India
Email subhashji@hotmail.com
References
1.
Lazzari S, Allengranzi B, Concia E. Making hospitals safer:
the need for a global strategy for infection control in health
settings. World Hospitals and Health Services 2004; 40: 32-39
The secretarial assistance of Ms Sarita Kumar is
acknowledged.
Correction to Vol. 40 No. 3
The following should have appeared on page 10
GREECE
40 | World Hospitals and Health Services | Vol. 40 No. 4