ENVI RONMENTAL T RANSMI S S ION
What can we learn from the Netherlands?
Dave Rudge argues that the UK could learn from the Netherlands’ holistic approach to infection prevention and highlights the need for further studies to provide high-quality data on the role of the environment in transmission.
There has been an ongoing debate within clinical settings about the reasons for, and the factors contributing to, the spread of healthcare-acquired infections (HCAIs) in the UK. The simple answer is that we must have a more holistic approach to infection control rather than relying on single-measure strategies and we must acknowledge the various complexities that are associated with HCAIs.
An increase in HCAIs over the years has forced Trusts to be more aware of how infections spread, resulting in an increase in surface disinfection and ward cleanliness. The COVID-19 pandemic that has affected the global population over the last year and a half is a demonstration of the importance of infection prevention.
HCAIs have been a common feature of previous novel coronavirus outbreaks1 research2
and
has shown that 11% of patients with COVID-19 in 314 hospitals over the most recent pandemic became infected after hospital admission, demonstrating that HCAIs are still a core feature of outbreaks. COVID-19 can persist on surfaces, which may be why there was a sharp rise in HCAIs as Trusts were under extreme pressure. However, there has been uncertainty around the transmission route of COVID-19. The pandemic has highlighted the need
for transmission of such HCAIs to be better understood and so that new processes can be introduced to reduce the burden of the spread of HCAIs in future.
The spread of HCAIs can be influenced by a range of factors, but it is the way in which we manage staff and patients that seems to have a critical impact. This can be demonstrated by the differentiating experiences of HCAIs in the Netherlands and the UK.
Whereas isolation rooms in the Netherlands were required to have an antechamber and be negatively pressurised, in the UK, positive patients were simply placed in ward side rooms. This action failed to acknowledge that contaminated clothing and bedding of colonised patients released S. aureus into the air when disturbed.
JANUARY 2022
The case of the Netherlands vs Europe in containing HCAIs The Netherlands were quick to adopt a Search-and-Destroy (S&D) approach to resist the spread of drug resistant bacteria, such as MRSA, and was introduced as soon as the first case of a drug-resistant disease was reported. The Dutch authorities sought a comprehensive strategy that isolated, contained and destroyed these diseases once detected. It focused on isolating patients that were considered to be of a higher risk for carrying MRSA and were segregated until cultures proved negative.
The same was introduced for hospital staff;
if they were found to be in close contact with a MRSA positive patient, they were screened and were banned from returning to the workplace until proven negative. While this was a time consuming and complicated approach overall, it was successful and did not cause any major clinical disruption. This approach ensured bacteraemia levels maintained at very low levels. A different story can be told for other European countries, such as the UK – where, in some cases, levels reached up to 50%.3
WWW.CLINICALSERVICESJOURNAL.COM l 65
▲
@
microgen@gmail.com
Page 1 |
Page 2 |
Page 3 |
Page 4 |
Page 5 |
Page 6 |
Page 7 |
Page 8 |
Page 9 |
Page 10 |
Page 11 |
Page 12 |
Page 13 |
Page 14 |
Page 15 |
Page 16 |
Page 17 |
Page 18 |
Page 19 |
Page 20 |
Page 21 |
Page 22 |
Page 23 |
Page 24 |
Page 25 |
Page 26 |
Page 27 |
Page 28 |
Page 29 |
Page 30 |
Page 31 |
Page 32 |
Page 33 |
Page 34 |
Page 35 |
Page 36 |
Page 37 |
Page 38 |
Page 39 |
Page 40 |
Page 41 |
Page 42 |
Page 43 |
Page 44 |
Page 45 |
Page 46 |
Page 47 |
Page 48 |
Page 49 |
Page 50 |
Page 51 |
Page 52 |
Page 53 |
Page 54 |
Page 55 |
Page 56 |
Page 57 |
Page 58 |
Page 59 |
Page 60 |
Page 61 |
Page 62 |
Page 63 |
Page 64 |
Page 65 |
Page 66 |
Page 67 |
Page 68 |
Page 69 |
Page 70 |
Page 71 |
Page 72 |
Page 73 |
Page 74 |
Page 75 |
Page 76 |
Page 77 |
Page 78 |
Page 79 |
Page 80 |
Page 81 |
Page 82 |
Page 83 |
Page 84
