Tuesday, May 01, 2007

Antiquated hospital plumbing linked to Pseudomonas deaths in Canada hospital

This is according to a report on a Pseudomonas aeruginosa outbreak that took place on a neonatal ward in a Montreal hospital in 2004-2005. After disinfection efforts failed to stem the outbreak the ward was closed. Pseudomonas, which likes stagnant water, was found, according to the investigation, festering in the sinks on the wards because the sinks did not drain properly.

There’s a pattern emerging. Outmoded facilities constitute an infection control problem. Canada faced a similar issue with the new highly virulent Clostridium difficile strain which broke out in Quebec hospitals. A study in CMAJ described the outbreak and highlighted the high attributable mortality. That paper concluded: The lack of investment in our hospitals infrastructure over several decades, with shared bathrooms being the rule rather than the exception, may have facilitated the transmission of this spore-forming pathogen, which can survive on environmental surfaces for months. Providing modern medical care within hospitals built a century ago is no longer acceptable.

An accompanying editorial noted we need to begin long-neglected upgrades in hospitals infrastructure, as there is a lag of almost a decade between the intention to build and the completion of projects and cited the related observation that the risk of nosocomial acquisition of methicillin-resistant Staphylococcus aureus, vancomycin-resistant enterococci and C. difficile was reduced 4-fold after the medical teaching unit at the Foothills Medical Centre in Calgary moved from a 5:1 to a 1:1 bed-toilet ratio.

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