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Last Updated: Friday, 9 November 2007, 18:13 GMT
Search and destroy the superbugs
Dr Jan Kluytmans
This is a national policy and each hospital has to spend whatever it takes to ensure patients are safeguarded. These are preventable infections.
Dr Jan Kluytmans

Hospital acquired infections kill around 50,000 people a year across Europe, according to the European Commission, and in 2008, the Commission plans to issue EU-wide guidelines on hygiene standards and control and prevention measures.

Getting a totally accurate picture is difficult, but according to the European Antimicrobial Resistance Surveillance System Britain fares amongst the worst, coming ahead of only Greece, Cyprus and Romania.

The Scandinavian countries and The Netherlands, by contrast, are among the best at keeping the spread of infections under control.

Modelled on Matron

The Dutch example is particularly interesting as their infection control methods (known as 'Search and Destroy') was modelled on a system pioneered by Britain and still used in our hospitals in the 1960s.

The Dutch have tight controls on the use of antibiotics and very high standards of hygiene in their hospitals.

All patients from high risk groups are tested for infections

They have also been able to remain in control of infections such as MRSA by testing all patients from high risk groups (including everyone from people who have been treated in foreign hospitals to pig farmers).

Anyone found to be infected with the bacterium is kept in isolation.

If there is a wider outbreak entire wards are shut down and nurses and doctors are tested too and kept off work if necessary.

Similar precautions are applied to patients who present symptoms of C. Difficile, so although the country has had outbreaks in the past they have been contained and have rarely resulted in casualties.

Designed to be cleaned

Infection control is helped by structural factors. Most Dutch hospitals have been built more recently than British ones, with smaller wards and a more single rooms available.

The design of floors, soft furnishings and curtains is also geared to make cleaning easier and more effective.

Hospitals are designed with cleaning in mind
At Amphia Hospital, the Netherlerlands' largest, and a centre of excellence for thoracic surgery, gleaming isolation rooms stand ready to be deployed.

But they have remained empty for some time: despite admitting 40,000 patients a year they have not had any serious cases of MRSA for 12 years.

Over the same period one patient has died of C Diff, but there is no proof it was acquired at the hospital.

Financial priority

Amphia's chief macrobiologist, Dr Jan Kluytmans, said the hospital spends about 230.000 euros a year, or 6 euros per patient to keep infections from spreading.

This is in spite of a big financial crisis which has already led to several managers being sacked.

"The costs are getting higher and the pressure is increasing on our system because more people tend to come in who carry these infections," he said.

"But ultimately this is a national policy and each hospital has to spend whatever it takes to ensure patients are safeguarded. These are preventable infections."

It is possible, though, to go too far in the fight to prevent hospital infections.

One brand new hospital in the north of the country planned to make most of its rooms single use.

They have had to reverse their policy - not because of cost implications, but because patients said they were feeling too lonely and bored in their individual rooms.

Not a prospect facing NHS patients any time soon.

The Politics Show is on BBC One at 12.10pm on Sunday, 11 November 2007. You can reach the programme by using the form below.

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