Nosocomial infection of scabies in national hospitals and sanatoria in Japan

Abstract

The aim of this study was to investigate cases of nosocomial infection of scabies in the national hospitals in Japan. Questionnaires sent to 183 hospitals and sanatoria were returned by 93. Fifty-three cases in 24 institutions of nosocomial infection were reported in the past 5 years. No nosocomial infection was reported from 7 sanatoria for Hansen's diseases where the patients were relatively older and had higher ADL scores. It took 7.5 weeks on the average to eliminate nosocomial infection and more than 8 weeks were required to control them in the hospitals where more than 10 cases had occurred. Benzyl benzoate, gamma benzene hexachloride, and Pyrethroids, which were not approved as drugs for the treatment of scabies in Japan, were used in the all institutions where nosocomial infection occurred except for one institution. Problems to be solved were as follows; (1) delay of diagnosis and treatment, (2) lack of nursing staff, (3) difficulties of complete isolation due to lack of spaces, inability of patients to understand the need for isolation and also the psychological instability of the isolated patients, (4) recurrence due to the use of ineffective drugs, (5) insufficient information about the prevalence of scabies in the previous institutions, (6) misdiagnosis of non-scabies patients with itchy skin rash as the scabies, (7) inconsisitent care due to poor evaluation of skin lesions.