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Infectiology and hospital hygiene

Skills in both tight linked areas are today more important than ever. The increasing number of infections with a simultaneously gain proof of multidrug resistant pathogens makes it necessary to prohibit the appearance of infections and when necessary initiating the right antibiotic therapy.  This hast to work fast and has to eliminate the chance of formation or selection of multidrug resistant pathogens.

Hospital hygiene has the goal to protect the patients against nosocomial infections.  An Infection is nosocomial if it occurs at the third day of a hospital stay, which means that the patient giant it at the hospital. But it has to be differentiated where the germ came from. This could be germs which are from the patient himself or germs which are transferred to him from the outside. We are all hosts of trillions of microorganisms, the skin, the upper respiratory tract, the genitourinary tract and mostly the bowl with the largest bacterial count in the colon. This is a very natural process which helps the people in many ways. But if however bacteria from the human flora gets into a operative wound, postoperative in to the urinary tract or in to the lungs these germs can develop in to serious or life threatening infections (endogenous infection).

On the second way pathogenic bacteria are transmitted from the outside to the patient. These bacteria can be transmitted for example from patient to patient or over the hands of employees or form the environment of the patient’s room (exogenous infection).

Hospital hygiene measures put on two points: in the environment of the patient and at the patient himself. Patients who are staying at the clinic St. Wolfgang are all staying in single rooms which means the transfer from patient to patient is minimized, all rooms are cleaned and sanitized according to the latest guidelines of the hospital hygiene commission and all employees are trained by our hygiene specialists on how to deal with patients.  One very important measure is the hygienic hand disinfection. The second point is the patients themselves. If there is for example any indication, which means risk factors, for the possibility that there is already colonization with multidrug-resistant pathogens on admission to the clinic St. Wolfgang, then a microbiological examination takes place. If patients are staying because of a surgical intervention the preoperative care, especially in the surgical field, is important for the prevention of postoperative wound infections. As it is the same with postoperative care. In such cases there is a clear course of action in the hygiene plan which is based on international scientific findings and guidelines.  In the rare case of a nosocomial infection there are additional measures in the hygiene plan which is immediately put into effect.  The hygiene plan of the clinic St. Wolfgang is secured electronically and every employee can have a look at it at every computer terminal. It depends not only on the topicality and quality but also the quick and easy access in terms of questions and problems. All nosocomial infections like pneumonia, postoperative wound infection, urinary tract infections, infections of the bones and joints and antibiotic – associated diarrhea are treated with an innovative, specially developed program recorded and regularly evaluated. This can be used over time to detect and eliminate any deficiencies and gaps in patient care!

In the period of January 2017 till September 2018 occurred overall 7 postoperative wound infections (5 superficial, 2 deep) with an incidence of overall 0,5%, 3 clinical defined pneumonia with an incidence of 0,26% as well as 2 urinary tract infections (0,17%) and one case of antibiotic – associated diarrhea. Those low numbers show the efficiency of the hospital hygienic measures and the responsible use of antibiotics.

All multi drug resistant pathogens (3MRGN) as well as one MRSA – truncus (acquired on an outpatient basis: CA-MRSA) detected in this period of time were brought by the patients. A transfer to other patients did not take place.

If a patient has already an infection when he checks in at the clinic St. Wolfgang or he gets a treatment worthy bacterial infection during his stay, he will get immediately the right antibiotic calculated therapy even bevor we have the results of the microbiological examination. In order to choose the right antibiotic there a various factors which have to be taken into account: location of the infection, severity and history, possible germination sources, condition after the operation, age, basic diseases, immune status, previous hospital stays, for example, with evidence of resistant germs or medical interventions, possible side effects of the antibiotic as well as travels and origin. In these cases as well, the therapeutic decisions of the physicians at the clinic St. Wolfgang are based on national and international guidelines but also on many years of personal experience in dealing with critically ill patients. As with hospital hygiene, the selection of the right antibiotic is supported by a specially designed program which is available to the physician. All therapies are recorded electronically and evaluated periodically in order to uncover trends and possible errors.