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Assume you work at the local hospital in your home town.Suddenly you notice that 10% of...

Assume you work at the local hospital in your home town.Suddenly you notice that 10% of your patients are having serious staphylococcal infections.None of these patients were admitted for having a staphylococcal infection, and we assume that all standard infectious control procedures are being followed (hand washing, use of gloves and masks, etc.).Remember that a small percentage of bacteria do evade even the most scrupulous of infectious disease control procedures.

How could you find out where the infection originated? What steps would you need to take?

How could you determine definitively what organism is causing these patients’ infections?

How could you determine how to treat these patients?

Once you determine the source of the infection, what ethical issues, if any, are involved here? What should you do to protect the privacy and welfare of the patients as well as avoiding conduct that would lead to a misconduct charge or lawsuit against the hospital?

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Answer #1

Rather than a complete cleaning and decontamination in hospital still the organism like staphylococcus are present in hospital setup.

It could have originated from

  • Invasive devices ( urinary catheter,dialysis tube,venflon, nasogastric or PEG tube,nasal cannula)
  • Low immune system
  • Any disease condition (Diabetes, HIV,AIDS,Respiratory illness, Kidney disease )

In case of these type of spreading

  • a thorough autoclave or sterilization of the articles to be done which are reusable
  • discarding non reusable articles
  • Disinfection of even pillows, mattress has ton be done.
  • Isolation of burns patients ,surgical patients

Staphylococcus aureus is the common form of definitive organism which can cause infections.

These patients after screening can be segregated or isolated only when necessary. ,antibiotics can be started as per need,monitoring for the intensity of infection and treating, treating underlying disease condition, healthcare professionals to strictly follow infection control protocols.

The ethical issues and the way to avoid misconduct can be the following

  • Whether the instrument or devices or materials were decintaminated regularly as per the standard
  • The skills and knowledge ofvthe staff handling it
  • Trying to treat the patients confidentially after informing the complete status to pagient if conscious and to relative if unconscious
  • Creating awareness
  • Health educating the patients and relatives about the risk factors and chabchances to acquire it .This makes them aware that it can spread from low immune system to any major medical procedure furing hospital stay and thereby preventing misconduct.
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