In 20 months, 252 patients were affected and 18 fell victims to the bacterial outbreak – could any of these have been avoided?

TO PLAY with public health is a very serious matter, which may cause general alarm, and cast discredit on the public health system.

In the case of the outbreak of the bacteria Acinetobacter baumanii which, in the course of 20 months, affected 252 patients in the Madrid hospital of 12 de Octubre, directly causing the death of 18 of them, it is all too easy to see the matter from a political angle.

But this should not distract our attention from the real problem: has the outbreak been treated with the necessary diligence? Could some of the damage have been avoided?

Hospital infections are, at the present time, one of the most serious challenges facing health institutions. Bacteria, as the living microorganisms which they are, defend themselves against medical attack by means of mutations which render them resistant to antibiotics.

To eradicate them completely seems to be a Utopian impossibility, but if a hospital shows more than a certain percentage of hospital infections, it is a clear sign that something is going wrong. Indeed, the infections rate has become one of the main indicators of quality in a hospital.

In the early 1990s, specialists in preventive medicine estimated that it was possible to reduce the infection rate to six percent, but in recent years the Epine study, which periodically analyses more than 55,000 clinical histories throughout Spain, shows that, far from this objective being reached, a worrying upturn is taking place.

While the Epine for 2005 showed a hospital infection rate of 6.9 percent, in the 2007 study it had risen to 7.9 percent. This means that almost eight of every 100 patients in Spanish hospitals contract an infection there, and that one in every 100 die of this cause. This is not, then, a minor problem: it causes more than 4,000 deaths each year.

The 20 months that the 12 de Octubre hospital took to control the outbreak seem excessive at first sight. A long time was also taken before deciding on the radical task of demolition and rebuilding in a section of the hospital where the bacteria had taken hold.

If to this, we add the existence of repeated formal complaints by hospital personnel, disdainfully ignored by the management, the suspicion of negligence looks more and more likely. Since the prosecutor's office has begun a criminal inquiry, the courts will have to determine whether there are any grounds for these suspicions.
The public has a right to expect that a hospital management will not endanger people's lives.

Viewed from this angle, the first reaction of the hospital management and of the health authorities from the regional government of Madrid to the publication of the news is not a very good sign. To attack the messenger, and defend yourself in terms of politics, does not seem to be a very good argument.

While it is true that bacteria exists in many hospitals, the public ought to know just why 20 months went by before measures were taken to rebuild the intensive care unit, and why no attention was paid to repeated complaints by hospital labour unions on the shortage of personnel and the deficiencies in general hygiene in the unit.

text by El Pais / Expatica
photos by Flickr contributor kaibara87