HEALTH

According to the French High Council for Public Hygiene, an infection is called 'nosocomial' if it did not exist when the patient was admitted to the hospital.

A real public health issue

Nosocomial infections are identified as a major public health issues due to their frequency, cost, and seriousness. The risk of being infected while in hospital is 7%, meaning that out of every 100 hospitalised people, 7 will contract a nosocomial infection. This number varies depending on the type of department where the patient is hospitalized. It may even reach as much as 30% in intensive care units.

In France, nosocomial infections affect annually between 700 000 and one million individuals.

They are a complication for 5 to 19% of inpatients in community hospitals and for up to 30% of patients in intensive care. On average, those infections extend the length of stay by 4-5 days.

It is estimated that there are approximately 9000 deaths are caused every year by nosocomial infections.
Multiple sources

Nosocomial infections are of two types:

endogenous infections when the patient is infected by his/her own pathogens. These appear when the health status of a patient is fragilized due to age, disease, treatments, quality of care, and the presence of pathogens. Endogenous infections account for at least 50% of nosocomial infections.
Exogenous infections, whether they are cross-infections from other patients, infections caused by germs carried by members of the staff, or infections related the hospital environment contamination.

At the source of these infections:

Poor hygiene practices. It was recently shown that the major cause for the transmission of bacteria was the lack of hygiene (no hand wash, no disinfection...).
Advancements in medical and surgical care with, for instance, increasingly more aggressive procedures and treatments which may be potential sources of infection.

The proportion of multiresistant bacteria strains among those causing infections in French hospitals, is one of the highest in Europe: 35% of all staphylococci identified in hospitals are methicilline-resistant, and the resistance of Klebsiellas to beta-lactamins is quite common...

A definite cost, more expensive than prevention

Nosocomial infections result in a major financial extra cost, mostly due to a longer hospital stay (4 days on average), anti-infectious therapy and laboratory exams required for the diagnosis and monitoring of the infection. It is estimated that a new infection increases by nearly 2 weeks the stay in an orthopaedic surgery unit, and by 300% the patient care costs.

The various available studies indicate a very wide cost scale ranging from an average 340 Euros for a urinary infection to 40 000 Euros for a severe bacteraemia in ICU. Thus, the estimates vary substantially depending on the anatomical site of the infection, the type of germ, the underlying disease, and also the type of hospital unit.

If we apply an extra cost mean value ranging from 3500 to 8000 Euros per infection to the annual 750 000 nosocomial infections, we reach a total expense of 2.4 to 6 billion Euros.

Lowering the number of infections by 10% would result in savings worth 240 to 600 million Euros, i.e. up to 6 times the prevention effort of hospitals which is about one hundred million Euros.

This quick calculation shows how much the non-quality cost is higher than that of prevention.

Public and private hospitals, doctors surgeries, laboratories

These facilities regularly receive patients who carry pathogens and have often an impaired immunity. To decrease or eliminate the potential for infections, surfaces with which the patient may be in contact should be submitted to thorough cleaning and disinfection processes. It is then essential to own a system for efficiently disinfecting/sterilizing 100% of a room surfaces (patients rooms, theatres, etc).

Major clients: Hôpital Pitié-Salpetrière, Hôpital Robert Debré, Institut Gustave Roussy, Institut Pasteur, Laboratoire Bio-Rad

Retirement homes, rehabilitation facilities, thalassotherapy centres

These institutions receive individuals for usually long periods. Most often, these patients have an impaired or depressed immunity. Even if nosocomial infections are less of a concern in those types of institutions, it is nevertheless necessary to remain careful and master the infectious risk, using a concept that will treat all the surfaces.

Major clients: List on request

Ambulances, firefighters

Ambulance and firefighters usually are emergency respondents, and transport every day a great number of persons. Each transported person may be potentially contaminated (or leave pathogens) on the surfaces with which this person was in contact, if no efficient disinfection procedure is implemented between every patient transports.

Major clients: Essonne Departmental Fire Service, ambulances (List on request)