Education And Debate

Preventing hospital acquired urinary and respiratory infection

BMJ 1995; 310 doi: (Published 03 June 1995) Cite this as: BMJ 1995;310:1452
  1. P J Sanderson, consultant microbiologista
  1. a Edgware General Hospital, Edgware, Middlesex HA8 0AD
  • Accepted 7 March 1995

Point prevalence surveys in different countries show that about 10% of patients acquire an infection while in hospital,1 2 3—a high proportion for what is assumed to be a preventable problem. Examination of hospital acquired infections of the urinary and respiratory tracts shows, however, that many of these infections are autogenous in origin and that only a part of the total will have arisen because infection control practices were inadequate. Indeed, if urinary catheterisation is regularly performed with adequate sterility and adequate respiratory care is given to postoperative patients then many hospitals may have reached an “irreducible minimum” of these infections, which cannot be prevented even in the best run hospitals.4

An irreducible minimum

What are the reasons for saying this? Urinary catheterisation opens the bladder to infection from organisms deposited on the catheter itself (from the hands of the operator, for example) and from organisms that gain access to the lumen of the catheter once it is in place. Sterile catheterisation techniques, …

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