Sounds like contamination control to me

04/01/2006

Having just returned from a few days in Europe, visiting SEMICON Europe as well as a hospital equipment show in the Czech Republic in preparation for the CleanRooms Europe Conference & Exhibition coming up this October in Brno, I thought it was particularly appropriate that our Special Report this month is addressing the subject of microbial contamination and infection control.

A common thread in all my conversations with the contamination-control companies I met with during my travels was, in fact, the growing interest in pursuing the hospital health-care marketplace in Europe. Nosocomial, or hospital-acquired infections (HAIs), are gaining increased attention worldwide, including in the US, but the problem has been getting particularly intensive recognition in the European health-care community.

In the US, the Centers for Disease Control and Prevention’s (CDC) National Nosocomial Infections Surveillance (NNIS) system estimates that there are two million HAIs annually in US hospitals, resulting in 90,000 deaths (one every six minutes) and $4.5 billion in health-care costs.

New strategies to deal with the problem, such as active surveillance cultures (ASCs) to screen patients, together with the strict implementation of barrier/isolation precautions (including negative-pressure ventilation rooms, gloves, garments, and masks) for colonized or infected patients, have proven successful in Europe. And, this approach is endorsed in a new guideline from the Society for Healthcare Epidemiology of America (SHEA). A number of US hospitals are now implementing such programs, including the University of Pennsylvania Medical Center Health System, where 16 hospitals will implement programs in their intensive-care units this year.

The CDC’s Healthcare Infection Control Practices Advisory Committee (HICPAC) will also soon release a guideline for airborne infection isolation rooms (AIIRs), to contain diseases transmitted by this route. Typically, AIIRs implement HEPA filtration with multiple changes of fresh air as well as filtered exhaust systems.

Surgical Site Infections (SSIs) represent the third most frequent nosocomial infections in hospitalized patients, with improperly sterilized surgical instruments being a continuing and serious problem. Even tiny amounts of biofilm remaining on an instrument can compromise the sterilization process and lead to cross-contamination. As a result, medical device manufacturers as well as sterilization professionals are being tasked to provide improvements in this area.

Another serious but not as often discussed contamination-control concern for a hospital is its water distribution system, where a host of dangerous microorganisms can reside. For example, according to CDC statistics, although 10 to 15 percent of Legionnaires’ disease (LD) cases are fatal, a large proportion of those deaths occur during nosocomial outbreaks.

The bacterial content of original source water to a hospital facility may, in fact, pose no health hazard at all. Problems arise if it ends up in a biofilm or another area with adequate temperature and nutrient conditions (such as baths, humidifiers, nebulizers, nasogastric tubes) where organisms can multiply and, ultimately, infect patients.

Although the rate of technology adoption and implementation may be debatable, one thing is clear. The infection-control requirements of the health-care community and the language being used to discuss those concerns and solutions are sounding an awful lot like contamination control.

John Haystead
Editor in Chief