At the one-day Conference on Hospital Infection Control, microbiologists, infection control officers and other experts engaged in lively, fruitful discussions about how to make hospital infection control a practice that is followed universally, and how to arrest the epidemic of antibiotic resistance. Here are a few choice remarks from the conference, and strategies suggested by experts to curtail India’s hospital-acquired infection rates:
Hospital infection is one of the most important topic for any hospital in this country to deal with. And why not? It’s a spine of a hospital operations. During his keynote address at Conference on Hospital Infection Control, Dr Hiren Ambegaokar, CEO, S.L. Raheja (A Fortis Associate) Hospital requested officials and doctors from various hospitals not to look at infection control practices as an additional cost burden. He explained how following the infection control protocols in the hospitals could save a lot of money on unnecessary antibiotics and would prevent secondary hospital infection, which will be helpful in the wake of epidemics.
Prof Dr Abhay Chowdhary, Professor and Head of Microbiology, DY Patil University School of Medicine, Hospital and Research Center was at his usual best while addressing the august gathering. He made some critical observations on hospital infection control. According to him, hospital infection is everyone’s baby, however, not many are taking care of it. Infections are preventable by implementing good infection control practices. However, lack of awareness and negligence at all levels results in budgetary constraints. Besides, contracting out cleaning services to untrained, unskilled labour who use obsolete and ineffective molecules have resulted in an overall deterioration in hospital hygiene practices.
Before the beginning of the panel discussion on Evaluation of Infection Control Issues in APAC, Dr Chowdhary set the tone of the session by recommending infection control programs in health care setups,, infection control committees to be set up in all health care institutions, and emphasised on the need for infection control teams, Standard Operating Procedures (SOPs) and immunization and vaccination of vaccine-preventable diseases.
Taking the discussion to the next level, Dr Prashant Nasa, HOD Critical Care Medicine, Chairman Prevention and Infection Control, Antimicrobial Stewardship, NMC Specialty Hospital, Dubai mentioned about the synchronized approach of UAE in preventing infections in the hospitals. “UAE receives around 90 million travellers per year. So the chances of epidemics spreading are immense. However, we have managed to prevent epidemic-like situations because of the synchronization of hospital data, which is lacking in India.”
During the panel discussion, Dr Parag Rindani, Associate Vice President, Wockhardt Hospitals Ltd, complained about indulging in obsolete practices like fumigation in the Indian hospitals. This shows we put all our money where we are not supposed to, but we don’t put our money where we are expected to, he said. His critical observation on the validation of data and funds utilization by hospitals garnered applause from the audience. He also lauded the government’s effort of creating a national accreditation and standardization process for infection control. Dr Rindani suggested that when it comes to infection control, it is very much important to first strategize on how to reduce the infection rates based on evidence-based medicine instead of following age-old practices.
The panel suggested some action points that include establishing government commitment and support for nation-wide antimicrobial programmes and within the policy, set up a national focal point for collaborations and compilation. Besides, establish a National Alliance for prevention and control of antimicrobial resistance. Also, institute a surveillance system that captures the emerging resistance, seeks and envisions trends in its spread and correlates with utilization of antimicrobial agents in the community as well as in health care setups. Strengthen infection prevention and control measures – healthcare associated and community based. Support research in developing newer antimicrobial agents and improving usage of available ones, based on pharmacological properties. Educate, train and motivate all stakeholders in rational and appropriate usage of antimicrobials and its regulation. Co-development of antimicrobial agents with pharmaceuticals and leaving the distribution, sales and promotion with the government was another measure suggested.
During the panel discussion on the ‘Need for Education and Training Specialist in Infection Control’ Dr Mehul Panchal, Consultant Clinical Microbiologist & Infection Control Chairperson, Kiran Multi Super Speciality Hospital & Research Center said that he believes Indian hospitals are prepared for pandemics like Ebola or COVID19. As far as achieving good infection control and patient management goes, we are in a different position because neither do we have total government setups nor are we dependent entirely on private setups. Commenting on the impending healthcare crisis awaited in India, he told other panelists that though such a crisis has not touched India in recent times, we are on the verge of an impending infectious crisis.
While commenting on the need for training, Dr Ami Varaiya, Infection Control Officer & Consultant Microbiologist, Balabhai Nanavati Hospital recommended the need for evidence-based practising and formal training to hospital staff, including doctors. She suggested starting a diploma course on special infection control. During the discussion, she raised concerns about the lack of skilled manpower in this sector which can be addressed by capacity building with the right kind of training.
According to Dr Ashto Mathur, Ex. Director Medical, Family Planning Association of India, HQ, Mumbai, the hospital establishment must not ignore the infection control process because when a patient is admitted in the hospital, it’s the job of the establishment to make sure he/she is not infected. In fact, in this regard, periodic training is necessary and guidelines are required for all infection prevention controls.
The session was moderated by Dr Dhruv K Mamtora, Consultant Clinical Microbiologist and Infection Control officer, S.L. Raheja – Fortis Associate Hospital.
While moderating the session on Technology to Reduce Healthcare Associated Infections, Dr Shashikala Shivaprakash – Head & Consultant, Department of Microbiology & Infection control, Sir H N Reliance Foundation Hospital, Mumbai talked about hand hygiene continuous monitoring system which is a social technological model with the use of micro ergonomic analysis device tool. Dr Prashant Nasa talked about automated sensors installed on the camera while entering the patient cubicle, but what kind of technology is applicable is dependent upon the surroundings. “The technology should send us real-time feedback for more improvement,” he said.
Dr Sweta Shah, Consultant, Microbiology and Infection Prevention, Kokilaben Dhirubhai Ambani Hospital and Research Institute spoke about automated decontamination devices or technologies such as UV lights, which work very well because it kills all the bacteria. Another option, she said, is an auto dispersion fogging machine.
Apart from these sessions, Dilip Lalwani, Chief Executive Officer, HAV-Gourmet and Venkat Raj, Head of Continuous Services (Asia), Lindstrom Services India Pvt Ltd presented their papers on housekeeping and laundry hygiene. Dr Aruna Poojary, Head of Dept, Dept of Pathology & Microbiology, Breach Candy Hospital Trust, Mumbai presented on the role of audits in IPC.