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Problem pests – vicious vectors 

With the rise in temperature over the summer months comes an increase in the number of flying insects that can make their way into homes, onto food and on car windscreens. In everyday life, they are simply an annoyance.

However, in healthcare environments, the presence of insects can be so much more sinister and a worry for hospital teams – even more so in warmer weather.
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In a recent study, 50 per cent of the insects found in seven hospital sites were found to carry bacteria which were resistant to one or more antibiotics, making preventive measures for their entry to hospitals and wards paramount. Image: martm|123rf

It goes without saying that hospitals are exceptionally clean places and teams work very hard to keep them that way, making sure they’re the safest possible places for patients to be seen, treated and to recover – therefore the risk of insects carrying bacteria and transferring these to patients is very low.

However, a recent report by researchers at Aston University, Birmingham, UK who collected almost 20,000 insect samples from seven National Health Service (NHS) hospital sites, found that more than 50 per cent of bacteria recovered from flying insects was found to be resistant to one or more antibiotics, posing a potential infection risk to patients.

Flying insects were collected from different places throughout the hospitals, including areas where food for patients, visitors and staff was prepared or stored, as well as high risk areas such as wards, neonatal units and maternity units.

Nearly nine in 10 of those insects tested were carrying potentially harmful bacteria including those that cause E.coli, salmonella and others that lead to skin infections and respiratory infections. The study found that, in some cases, the level of bacteria carried by flying insects was enough to potentially cause infection.

The paper is not criticising hospitals – it simply points out that, even in the cleanest of environments, it’s important to take steps continually so as to prevent bacteria from being brought into hospitals by insects.

There are, of course, many measures in place throughout hospitals – both in their permanent infrastructure, temporary infrastructure and in the materials they use, such as medical instruments.

Insects can enter from the immediate surroundings, near the building itself or from further afield via by visitors or staff on clothing, food, flowers or other items. While it may be difficult to stem the entry of pests by visitors, educating all staff about prevention within the facility can reduce problems – for example, flowers are now widely banned.

Hospitals can take other simple, precautionary measures – entry doors should be designed to reduce or prevent entry of flying pests and always be closed. Likewise, windows should be properly screened and utility openings properly closed off. Well-maintained plumbing systems, properly stored food and of course, cleanliness, are all key to keeping the bugs at bay. It is also vital to ensure the proper sterilisation of medical instruments and their sterile movement around the hospital.

Insects are just one concern and they play a relatively small role in the transfer of bacteria, so the risk they pose should be seen in the context of wider efforts to stop the spread of harmful and drug-resistant bacteria that put patients at risk.

How else might bacteria affect a person being treated in hospital?

Surgical Site Infections (SSI) remain the most reported health acquired infection and common surgical complication in both developed and developing countries.

Every year in the USA, an estimated 300,000 patients develop surgical site infections, which are responsible for over 10,000 deaths, and cost the health care system billions of dollars. In the UK’s NHS hospitals, surgery results in over 100,000 surgical site infections each year. An estimated 40-60 per cent of these infections are preventable.

They are a major clinical problem in terms of morbidity, mortality, length of hospital stay, and overall direct and indirect costs worldwide. Despite progress in prevention knowledge, SSIs remain one of the most common adverse events in hospitals.

Preventing SSIs is complex and requires the integration of a range of measures – the World Health Organisation recommends 29 different measures before, during and after surgery. These range from simple precautions, such as ensuring that patients bathe or shower before surgery, appropriate ways for surgical teams to clean their hands, guidance on when to use prophylactic antibiotics and which disinfectants to use before incision, to which sutures to use.

We know that bacteria are becoming increasingly resistant to antibiotics, which makes SSI prevention even more important – it’s a global healthcare priority.

So, while we may be irritated by this summer’s insects, we should remember that some bugs are not just irritating – they can be deadly.

This blog is contributed by Q-bital Healthcare Solutions, a UK-based company that provides mobile healthcare facilities to national health services around the world. It has more than 20 years of expertise in the field with over 275,000 procedures having been performed in its manned facilities. Q-bital is a Key Network Partner of CRJ. 

Ruth Wozencroft, 08/08/2019
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