14 October 2008

Sign of the times: Taking your own cleaning materials to the hospital

There are several new and important reports out on hospital-acquired infections (HAIs) that I hope to get to this week, but I spotted something today that I just had to highlight first:

Constant readers may know that I've done a lot of reporting in the developing world. In parts of Asia and Africa, it is assumed that patients or their families bring food to the hospital. People do not trust the hospitals to feed them, with good reason: Hospitals can't afford it. Provision of food in the hospital, which we take for granted, is not part of the health-care culture. (In particularly poor countries, the family may feed not only the patient, but the health care workers taking care of the patient as well.)

Here now is an industrialized-world version of that developing-world practice. A company in England (which, as we've discussed, has ferocious rates of hospital MRSA and C. difficile) has begun marketing the PatientPak, the "world's first personal anti-superbug kit." It's a $28 sample-sized collection of antimicrobial hair and body wash, hand wipes, hand sanitizer and a germ-killing spray for sheets and cubicle curtains, along with lip balm, bar soap, and a disposable nail brush and pen.

It's entirely possible that using products like this might protect a patient from some hospital-acquired infections; the company suggests that a patient use the wipes and the hand spray when going to and from the bathroom or after touching any surfaces. But the difficult reality, of course, is that most hospital-acquired infections are not the patient's fault: They are due to infection-control breaches by hospital staff, something over which a patient — with antimicrobial wipes or without — has little control.

This company will probably sell quite a few of these kits — and I don't know that I can criticize them for doing so. If one of my family members was being admitted to hospital, I might well send something like this with them. But what a sad commentary on our own health-care culture that any of us would consider this necessary.

1 comment:

daedalus2u said...

I have mixed feelings about this approach too.

In a home setting the use of antibacterial products doesn’t cause a demonstrable reduction in infections.


That might not apply in a hospital setting.

What I find objectionable about this specific product is that no where on their website do they disclose what the mechanisms of antimicrobial activity are or what specific agents are used. 99.99% reduction doesn’t necessarily mean very much because bacteria increase exponentially and can increase 10,000 times in 14 doubling times which can be less than 5 hours.

Killing off normal commensals can leave the niche open for something opportunistic. That is one of the major health promoting functions of our commensal bacteria, the suppression of bacteria that cause disease.