3. Hygiene Management

Given the fact that infection rates are increasing worldwide, it is exceedingly important to protect patients and staff effectively against the risk of infection. Hospital hygiene is therefore a fixed element in our quality concept.

The Group-wide RHÖN-KLINIKUM AG hygiene management system is a mix of centrally and decentrally organised measures. The centralised organisation’s priorities cover the detection of and the systematic, constant monitoring of multi-resistant bacteria, alongside the comparison of these bacteria with data from within RHÖN-KLINIKUM AG and also with national reference data (surveillance). In this way, the infection and antibiotics consumption data is systematically recorded. In addition, relevant quality data is collected in the areas of sterilisation and purification equipment, and the employment of qualified hygiene specialists in the clinics is centrally monitored.

Under the coordination of the Group Medical Division, two specialists have been appointed who represent the relevant specialist content in the area of hospital hygiene and infection control Group-wide: Prof. Dr. Thomas Eikmann, Directorof the Institute for Hygiene and Environmental Medicine at the University Hospital Giessen und Marburg, oversees the technical aspects of hospital hygiene. His Marburg colleague, Prof. Dr. Rainier Mutters, Director of Hospital Hygiene at the University Hospital Giessen und Marburg’s Institute for Microbiology and Hospital Hygiene, is responsible for the infection control aspects of hospital hygiene.

ANTIBIOTICS RESISTANCE OF BACTERIA IS INCREASING

One of the major problems in clinics is the issue of microbes that are resistant to antibiotics. An increasing number of bacteria are not affected by antibiotics. For healthy people, these pathogens are usually not a problem, but in people with a weakened immune system, the body’s own defence system often has no chance of winning against them. If a resistance to antibiotics then occurs at the same time, effective treatment is clearly made more difficult. The most well-known multi-resistant bacteria in hospitals are called MRSA and MRGN.

If the bacterium Staphylococcus aureus, which many people have on their skin, becomes resistant to various antibiotics, it is referred to as MSRA: Methicillin-resistant Staphylococcus aureus. MRSA bacteria occur in high concentrations inside the nose, on the skin, in open wounds and sometimes also in metabolic waste. MSRA are transmitted to other people mainly via the hands, but also through sneezing and coughing. However, usually this only becomes problematic if the bacteria move from the skin into the body.

Before a patient is admitted to one of our clinics, we therefore carry out what is known as a 10-point screening test to check for the presence of MSRA pathogens. If that is the case, certain measures such as removing the bacteria by washing with disinfectant are initiated, not least also to protect the patient himself from becoming infected after an operation. In addition, patients who are found to carry these pathogens at a later point in time are immediately isolated to prevent the infection of other people.

The more robust MRGN bacteria are even more difficult to control than MSRA. These pathogens, which are called Multi-resistant Gram-negative bacteria, can also become resistant to many antibiotics. A high concentration of MRGN bacteria can be present in faeces and urine, sometimes also in open wounds. In addition, they are sometimes also found on the skin and on mucous membranes. MRGN are again transmitted to other people mainly via the hands. This clearly shows how important regular and thorough hand disinfection is – and this applies to medical staff, patients, and all visitors.

In the medical sector, we have continued to expand the organisation and qualification of staff to become what are known as antibiotic stewards. With this, we intend to tackle the increasing resistance to antibiotics of hospital pathogens through an optimised antibiotics treatment. This not only equals a better quality of treatment for patients but also results in considerable potential cost savings.

In late 2014, a study was initiated that will standardise the screening for multi-resistant organisms in a sound scientific manner at the RHÖN-KLINIKUM AG locations. We are also carrying out a MRSA assessment test with 300 patients who did not undergo the 10-point check. The aim is to determine the number of potential pathogen carriers.