HOSPITAL INFECTIONS AND HOSPITAL HYGIENE AT MALMOE GENERAL HOSPITAL. 2. HYGIENIC MEASURES AND THEIR CORRELATION WITH THE INCIDENCE OF INFECTION

A hygienic programme, which has been developed and maintained during several years at a large Swedish university hospital, is presented in detail. The composition and working methods of the Infection Control Committee are described and some economic calculations given. The possible connexion between the hygienic measures and a marked decrease of the incidence of infections is discussed. This decrease did not occur until a satisfactory method for the routine hand disinfection had been introduced, using a commercial antibacterial cleaner containing 3% hexachlorophene.

THE MECHANISM AND PREVENTION OF CROSS-INFECTION IN DERMATOLOGICAL WARDS

Over a 2-year period a dermatology department was shown to be a valid model for the long-term study of hospital cross-infection. In the absence of specific anti-bacterial measures, consistently high levels of Staph. aureus and Gram-negative bacilli were found throughout the environment. ‘Broadcasts’ of Staph. aureus were particularly evident in the bathrooms, and notable sites of heavy, cumulative contamination were the communal baths, bedding, settled dust, and the hands of the staff.

Cross-infection of lesions occurred in ninety-four of the 233 ‘uncontrolled’ patients—15 cases being due to Gram-negative bacilli. Autogenous infection occurred in another fifteen cases. Nasal carriage of Staph. aureus developed in fifty-one patients after admission.

In one of the two main wards nasal disinfection (with ‘Soframycin’ nebulizers) was used for 4 months, and was effective in the treatment and prevention of nasal carriage; but it produced no change in the level of environmental contamination or in the incidence of cross-infection—even though efficient cleansing of the baths was also instituted. In contrast, during two separate periods of the work disinfection of skin lesions (with ‘Rikospray Antibiotic’) markedly reduced the counts of pathogens in the environment, and virtually abolished both cross-infection and the development of nasal carriage.

HOSPITAL INFECTIONS AND HOSPITAL HYGIENE AT MALMOE GENERAL HOSPITAL. 1. THE INCIDENCE OF STAPHYLOCOCCAL INFECTIONS DURING THREE YEARS

The incidence of purulent staphylococcal infections at a large Swedish university hospital was followed during 3 years and has been described as an expression of the incidence of hospital infections.

A marked decrease in the relative number of infections was found. The decrease was most evident among infections with ‘80/81’ strains and other antibiotic resistant hospital strains and was parallel in all the departments investigated. This is taken as an evidence for the assumption that the lowering of the amount of staphylococcal infections was brought about by a factor that was active throughout the hospital, probably some hygienic preventive measure.

VENEREAL DISEASE EDUCATION IN WASHINGTON, D.C

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