Patient safety -- mission for the future: Healthcare-associated infections and antibiotic resistance

Abstract

Healthcare-associated infections (HAI) are considered as one of the major challenges for modern health care. In the context of demographic change and the expected increase of invasive and complex patient treatment and concommittantrise in numbers of patients with underlying diseases with susceptibility to infections, quality of care and patient safety will in the near future depend strongly on the prevention of HAI. To avoid preventable HAI in terms of improved quality of care is beyond question, therefore mainly the prevalence of highly resistant microorganisms (HRMO) will becrucial for the success of treatment of unpreventable HAI. In addition to MRSA, the greatest danger in relation to antibiotic resistance worldwide are now considered tob e carbapenem-resistant Enterobacteriaceae (CRE) or multidrug-resistant Gram-negative (4MRGN) bacteria. In case oft he uncontrolled spread of HRMO unpreventable infections become also untreatable. The prevalence of HRMO varies between different countries. Especially in the Netherlands and Denmark HRMO such as MRSA, VRE and CRE/4MRGN are still significantly less common than in Germany or France. The reason lies in the fact that in nearly all Dutch hospitals anintegrative infectious disease service (clinical microbiology and/or infectious diseaseas wellinfection prevention) was established already years ago, while in Germany - with few exceptions - in most hospitals only a basic infectious disease services (consulting hygienist, microbiological diagnosis is held by laboratories often far away from the patient). As hospitals are connected with each other with respect to theircommon care of patients, one of the most important challenges in future infection prevention will be the implementation of regional and intersectoral infection prevention and control.