Dr. Semmelweiss Was Right: Washing Hands Prevents Infection
Last year marked the 150th anniversary of one of the most important medical discoveries. In 1847, Dr. Ignaz Semmelweiss, a physician in a Vienna hospital, discovered that fatal infections were spread among patients by doctors who failed to wash their hands between examinations. Semmelweiss immediately instituted a disinfecting procedure whereby physicians were required to wash in a chloride of lime solution after autopsies and with soap and water between patient visits. Doctors also had to change into clean lab coats before examining patients. As a result, hospital mortality rates from infectious diseases declined.
Today, hand washing should be a simple, standard antiseptic technique employed in hospitals and other health care settings to prevent the spread of illnesses. However, studies conducted at hospitals worldwide over the past three decades have shown that many doctors and nurses do not follow this practice.
Prevalence of Hospital-Acquired Infections
The U.S. Centers for Disease Control and Prevention (CDC) estimates that 2.4 million Americans acquire an infection in hospitals each year and that half of these infections are preventable by proper hand washing. Furthermore, hospital-acquired infections cause or contribute to 100,000 deaths annually, according to CDC officials. Patient-to-patient transmission of infectious microorganisms can occur via the hands of hospital personnel and contact with contaminated patient-care equipment or surrounding surfaces. Some viruses can survive for up to three hours on inanimate surfaces, such as doorknobs.
A 1994 CDC report, "Hand Washing - The Semmelweiss Lesson Forgotten?" notes that programs to improve hand washing practices have had limited success. Operation Clean Hands, sponsored by the American Society for Microbiology (ASM), was launched in 1996 to educate health care professionals and the general public about health risks associated with poor hand washing habits. The American Medical Association (AMA), in cooperation with the Joint Commission on Accreditation of Health Care Organizations, adopted resolutions in 1995 and 1996 to improve hand washing practices in celebration of the 150th anniversary of Semmelweiss' discovery.
Antibiotic Resistance Poses Risks
Both the ASM and the AMA caution that an over-reliance on antibiotics, rather than hand washing, for infection control poses a serious public health risk for outbreaks of antibiotic-resistant infections and can be especially dangerous for immunocompromised patients. Thirty-five years ago, most infections could be successfully treated with standard antibiotics, such as penicillin.
The CDC has now warned doctors and public health officials of the rapid ncrease of infections caused by drug-resistant bacteria -- bacteria that can mutate to protect themselves against an antibiotic -- particularly those resistant to vancomycin, an expensive and powerful antibiotic that is used as a last resort to treat the most virulent infections. Currently, about 95 percent of the infections caused by Staphylococcus aureus, one of the most common germs in hospitals, are resistant to penicillin and, increasingly, to vancomycin.
Infectious diseases remain the leading cause of death and disease worldwide and the third leading cause of death in the United States. Hand washing is the first line of defense against infectious diseases. Physicians who wear gloves also should wash their hands because gloves may become perforated during use and because bacteria can multiply rapidly on sweaty, gloved hands. In addition, gloves may protect the wearer but not necessarily the patient. The CDC's Guidelines for Hand Washing and Hospital Environmental Control note that hand washing is still considered the single most important procedure for preventing the spread of infections and should be practiced regularly as part of appropriate hospital infection control measures.
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