Improper decontamination and overuse of antibiotics are the two main causes of hospital infections that claim more lives than road accidents. There are 7.000 deaths each year from hospital infections compared to approximately 3.500 that occurred on the roads last year. This is the alarm raised by experts in the sector during the national forum promoted by the Centro Studi Mediterranea Europa in Naples. “The phenomenon is extremely worrying – underlined Massimo Clementi, dean of the Faculty of Medicine and Surgery of the San Raffaele University of Milan, who held a Lectio Magistralis – We need to understand the reasons for this increase, and implement all the policies to contain it. A very important method is environmental decontamination, Clementi pointed out, followed by timely microbiological intervention". The Aosta Valley holds the record for infections after surgery, with 500 cases per 100 discharged patients. Liguria follows with 454 and Emilia Romagna with 416. Lombardy, Veneto, Umbria and the city of Trento are just behind, with around 300, more or less. In Lazio the number reached 211, while in the whole of the South only Calabria exceeded 200. The most virtuous is Abruzzo with only 70 infections. According to the “2016 Report on Antibiotic Resistance and Use of Antibiotics Detected in Hospital Facilities in Campania”, approximately 50 cases of infections have been recorded in hospitals, 22% of which are caused by Escherichia Coli, 12,5% by Staphylococcus Aureus, and 9% by Klebsiella Pneumoniae. The departments where it is easier to become infected are Intensive Care (20,60% of cases), Medicine (15,33%) and Surgery (14,20%). “Healthcare-associated infections (HAI) represent one of the thorniest problems in healthcare at a global level today – said Alessandro Perrella, an infectious disease specialist from Naples at Cardarelli Hospital – In Italy, most HAIs are due to bacterial species that are resistant to antibiotics. However, approximately 50 percent of ICAs are substantially predictable and therefore avoidable, through a series of professional behaviors defined as 'safe'. Correct control of these factors requires the implementation of all necessary corrective measures”. “It is no longer tolerable that there are people who are admitted to a health facility for treatment, and come out with a more serious pathology than the one for which they went to the doctors,” was the peremptory comment of the newly elected vice president of the Health Commission of the Chamber of Deputies, Michela Rostan. “Our country cannot tolerate seven thousand victims every year,” he said, “because our facilities do not pay due attention to disinfection and decontamination. In the coming days, I will bring this very delicate issue to the attention of the Commission and I will propose the immediate adoption of extraordinary measures to reduce the number of infected people below the minimum acceptable threshold in a country like ours". The LeU MP underlined that there are already solutions within reach. “Advanced technologies and some best operational practices in Italy in terms of prevention of IOs should be taken as a model – concludes Rostan – For example, the experiences of the hospital in Aosta and those of some private facilities in Lombardy allow us to reduce pathogens below the danger threshold while developing, at the same time, a system for controlling the microbial load in confined environments capable of keeping any possible outbreak under control”. Alongside the issue of decontamination, another concern is the antibiotic resistance of many bacterial forms, as underlined by regional councilor Michele Schiano di Visconti, who is also a surgeon. “A diffusion that must be constantly monitored, especially in hospital settings, where it is responsible for complications that can lead to death – he said – In addition to spreading a culture of conscious and responsible use of antibiotics, we must also make a change in the adoption of decontamination and disinfection systems that are able to make workplaces safe, starting with hospital sites”. The effects of hospital infections not only on the health of patients but also on the pockets of taxpayers. “A silent massacre on which the spotlight is rarely turned and the reasons are easy to understand. It is a problem that affects about half a million people in our country – underlined Gaspare Saturno, number one of the Mediterranean Europe Study Center – Of these, a percentage that varies between 5% and 17% of hospitalized patients contract an infection and for 3% of them the outcome is fatal. These are numbers that must necessarily be reduced if we want to talk about a national health service worthy of the name and the tradition that Italy boasts worldwide in this sector". A phenomenon that has been underestimated for too long and which has very serious repercussions on public finances. In his report, Professor Roberto Lombardi of the Inail Technological Innovation Department highlighted, extrapolating the contents of a study by the Ceis of the University of Tor Vergata, the impact of the adoption of good practices, targeted research and technological innovation in the field of decontamination and disinfection on public spending, implementing the current sector legislation. According to the study mentioned, for each hospital infection between 9 and 10 euros go up in smoke. The cost of litigation for IOs, approximately 4 per thousand beds, is equal to approximately 4% of the total cost of claims in public healthcare and involves on average a total compensation of 8 million euros per year. It is also further emphasized that an appropriate disinfection, as indicated by the European technical standards, an increase in application studies in order to take advantage of innovative technologies, can put an end to this waste and guarantee safe management also for the evident problem of growing antibiotic resistance. All’incontro hanno partecipato, tra gli altri, Domenico Falco (presidente del Corecom Campania), Maria Galdo (Società Italiana Farmacisti Ospedalieri), Stefania D’Auria (Hcrm – Hospital & Clinical Risk Managers), Oreste Caporale (dirigente medico del dipartimento igiene e medicina del lavoro e prevenzione, Azienda Universitaria “Federico II” di Napoli), Maria Rosaria Esposito (Anipio, Società Scientifica Nazionale Infermieri Specialisti nel Rischio Infettivo) Nicola Ammaccapane e Gennaro Carrino (vicepresidente e segretario generale del Centro Studi Mediterranea Europa).
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