Quebec increases funding to fight infections in hospitals
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《英国医生杂志》
The Quebec government has announced that it will increase funding for hospitals?infection control programmes by $C20m (?.6m; $16.1m; �12.4m). Meanwhile preliminary findings have indicated that Clostridium difficile infections in the province抯 hospitals have dropped substantially from levels in last year抯 outbreak.
The infection was said last June to have killed more Canadians than were killed by the 2003 outbreak of severe acute respiratory syndrome (SARS) (BMJ 2004;328:1457).
Among 88 hospitals in the province, the median infection rate was 11.7 people per 10 000 hospital days from the end of last August to mid-November. In Montreal抯 McGill University Health Centre—five teaching hospitals affiliated with the McGill University medical faculty—there were 15.6 infections per 10 000 patient days from mid-August 2004 to mid-January 2005, down from 23.6 infections per 10 000 patient days from mid-August 2003 to mid-January 2004. The actual numbers of cases at the centre in the same periods were 167 and 251, respectively.
The surveillance programme, which the government says is the first in Canada to analyse and diffuse information on hospital acquired infections, shows that hospitals with more than 250 beds had infection rates twice as high as hospitals with 100 beds or fewer. The reason is that large hospitals offer more specialised care to patients who often have more serious illnesses, making them more vulnerable to hospital acquired infections. A higher rate of infections was also seen in hospitals where patients are older.
The surveillance funds have made it possible for hospitals to increase their housekeeping personnel and to buy disinfecting equipment and articles such as gloves and clothing. They have also been able to increase the installation of sanitary equipment used by patients and hospital staff. At the same time, an expert committee has been set up to look at the prevention and control of hospital acquired infections, so as to direct the efforts of clinicians, managers, and public health authorities. The committee will report on 30 April on the results of the programme.
Ann Lynch, director of clinical operations at the McGill centre, said people working at the centre are "making an extraordinary effort to meet the C difficile challenge." She called the downward trend of infections "encouraging." Tests of isolates from Quebec at the US Centers for Disease Control and Prevention show that the strain involved is new to Canada, more virulent than earlier strains, and identical to those causing recent outbreaks in the United States.
Infection control measures taken by the McGill centre include closer monitoring of use of antibiotics, reducing the number of patients per room on units that have experienced persistent outbreaks, and making C difficile diagnostic tests available on a daily basis
For more information see www.msss.gouv.qc.ca/cdifficile
?(Quebec David Spurgeon)
The infection was said last June to have killed more Canadians than were killed by the 2003 outbreak of severe acute respiratory syndrome (SARS) (BMJ 2004;328:1457).
Among 88 hospitals in the province, the median infection rate was 11.7 people per 10 000 hospital days from the end of last August to mid-November. In Montreal抯 McGill University Health Centre—five teaching hospitals affiliated with the McGill University medical faculty—there were 15.6 infections per 10 000 patient days from mid-August 2004 to mid-January 2005, down from 23.6 infections per 10 000 patient days from mid-August 2003 to mid-January 2004. The actual numbers of cases at the centre in the same periods were 167 and 251, respectively.
The surveillance programme, which the government says is the first in Canada to analyse and diffuse information on hospital acquired infections, shows that hospitals with more than 250 beds had infection rates twice as high as hospitals with 100 beds or fewer. The reason is that large hospitals offer more specialised care to patients who often have more serious illnesses, making them more vulnerable to hospital acquired infections. A higher rate of infections was also seen in hospitals where patients are older.
The surveillance funds have made it possible for hospitals to increase their housekeeping personnel and to buy disinfecting equipment and articles such as gloves and clothing. They have also been able to increase the installation of sanitary equipment used by patients and hospital staff. At the same time, an expert committee has been set up to look at the prevention and control of hospital acquired infections, so as to direct the efforts of clinicians, managers, and public health authorities. The committee will report on 30 April on the results of the programme.
Ann Lynch, director of clinical operations at the McGill centre, said people working at the centre are "making an extraordinary effort to meet the C difficile challenge." She called the downward trend of infections "encouraging." Tests of isolates from Quebec at the US Centers for Disease Control and Prevention show that the strain involved is new to Canada, more virulent than earlier strains, and identical to those causing recent outbreaks in the United States.
Infection control measures taken by the McGill centre include closer monitoring of use of antibiotics, reducing the number of patients per room on units that have experienced persistent outbreaks, and making C difficile diagnostic tests available on a daily basis
For more information see www.msss.gouv.qc.ca/cdifficile
?(Quebec David Spurgeon)