Rate of health care-associated infections in developing countries more than double U.S., European rates, study finds

The rate of health care-associated infections in developing countries is more than three times the rate of cases in the U.S. and more than double the rate in Europe, according to a study published Friday in the Lancet, BBC reports (12/9).

According to the Lancet, researchers analyzed 220 articles published between 1995-2008 that contained "full or partial data from developing countries related to infection prevalence or incidence - including overall health care-associated infection [such as urinary-tract infection, surgical-site infection, bloodstream infection, hospital-acquired pneumonia, and ventilator-associated pneumonia] and major infection sites, and their microbiological cause" (Allegranzi et al., 12/10).

"Researchers found the infection rate in developing countries was 15.5 per 100 patients," compared to "7.1 [per 100 patients] in Europe "and in the U.S., 4.5," BBC writes. "The difference in intensive care infections was even greater. In developing countries, infection rates were 47.9 per 1,000 patient-days, compared to 13.6 in the U.S.," the news service adds (12/9).

"Health care-associated infections have long been established as the biggest cause of avoidable harm and unnecessary death in the health systems of high income countries. We now know that the situation in developing countries is even worse," Benedetta Allegranzi, Technical Lead for the Clean Care is Safer Care programme at the WHO and co-author of the Lancet study said, according to a WHO press release. "One in three patients having surgery in some settings with limited resources becomes infected. Solutions exist, and the time to act is now. The cost of delay is even more lives tragically lost."

The release summarizes several factors believed to increase the risk of health care-associated infections, including poor hygiene and waste disposal practices, "inadequate infrastructure and equipment" and a "lack of basic infection control knowledge and implementation." The release continues: "Implementing system-wide surveillance, training, education and good communication, using devices appropriately and following proper procedures, and ensuring optimal hand hygiene practices are some of the solutions that must be tailored to the reality of these settings. To be successful, these solutions ultimately require a change of health care workers' behaviour - in all settings" (12/10).

"As a result of improved surveillance of health care-associated infection worldwide, and with the objective to raise awareness among policy makers and health-care workers, now could be the time to investigate epidemiological models that allow inclusion of health care-associated infection in the list of major diseases causing morbidity, mortality, and disability, which are regularly reported by WHO and other institutions within global estimates of burden of disease," the authors of the Lancet study conclude (12/10).

Lancet features an accompanying Comment that examines the results of the health care-associated infections study (Rosenthal, 12/10).