Control of Hospital Acquired Infection in Bangladesh - An Endeavor to be Strengthened

Abstract

Nosocomial or hospital acquired infection is a major cause of morbidity and mortality of patients attending the healthcare facilities all over the world. The issue of infection associated with medical practice probably dates back to over two thousand years when the medical healer started to practice surgical procedures.1 In the last two hundred years it has emerged as a matter of great concern with the rapid advancement of medical science. In the 1800s as many as 80% of all operations ended in infection. 2 For a long time medics refused to acknowledge the fact that infection could be afflicted by the healer during treatment until in mid 19th century, when Ignaz Philip Semmelweis in Vienna demonstrated the relationship between hand washing with chlorinated water and reduction of puerperal sepsis. He successfully demonstrated a dramatic reduction in the incidence of puerperal sepsis from over 8% to 2.3 % only by insisting on stringent hand washing with a solution of chlorinated water.2 The importance of controlling hospital infection was finally recognized by the work of Joseph Lister in mid sixties of 19th century by publication of his landmark paper ‘On the Antiseptic Principle in the Practice of Surgery’ in the British Medical Journal. He recognized the role of microbes and the use of carbolic acid, an antiseptic solution, in controlling surgical wound infections. These observations provided the basis for control of hospital acquired infections and thereby the importance of infection control was conceptualized. However, the introduction of penicillin in 1941 brought a negative blow to infection control practices in hospitals on a false perception that ‘penicillin the magic bullet’ would readily alleviate this problem. As a result, there was rapid decline in interest in hospital infection control activities. But this euphoria did not last long because of the outbreak of large staphylococcal pandemics in the 1950s which resulted in renewed interest on infection control programs in hospitals.3