Jumat, 25 Maret 2011

Blaming the health care worker: KPCs in Ireland

Mike posted yesterday about KPCs in LA, and now there is a report of a KPC outbreak in Ireland. I have read several reports of the outbreak, which involved 5-7 patients (two infected, three colonized) at the Mid-Western Regional Hospital in Limerick, and there is one consistent aspect to what is reported:  It's the health care workers fault. See the article "Hospital Staff Warned" in the Irish Times.

The articles state that "steps had been taken to improve hand hygiene standards among hospital staff but warned that a zero-tolerance approach was being enforced in respect of anyone who failed to comply with these standards" and that "This will include disciplinary action and or notification to relevant professional registration bodies if warranted in any particular case." 

Mike has written before about the dangers of this adversarial approach to infection prevention, so I won't belabor the point.  However, when the authorities state that they are already doing everything right since MRSA and C. diff prevention efforts are all you need to control KPC, I get a bit worried.  There is no evidence that this one-size-fits-all approach works for infection prevention.  Yes, compliance with infection prevention is important, but there must be other approaches besides punishing the health care worker that will protect our patients. 

The larger problem is that little to no research funding is available to study the epidemiology and optimal prevention methods for Gram-negative (or Gram-positive) bacteria.  Before we blame the health care worker, perhaps we could ask why there is almost no funding for infection prevention research and implementation and why there are no new antibiotic classes in the pipeline.  You do get what you pay for...

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