IT WAS SUPPOSED to be the best week of her life.
Liza Lindham, 32, had just given birth to her first child in Stockholm in June 2014. The delivery was tough, because the baby’s head had blocked her bladder. Medics drained the urine with a catheter. Finally, with a healthy baby girl in her arms, Liza returned home, exhausted but exhilarated.
But she grew more and more tired. A few days later, she felt like she’d caught a cold, so she curled up in front of the TV. Her aches and pains got worse. By dinner time, she couldn’t eat, and was shivering violently. “Something’s wrong,” she told her husband. Liza didn’t know it yet, but she’d picked up a urinary tract infection (UTI), a common complication of catheter use, when bacteria such as E. coli travel from the gut to the bladder. Unnoticed, the UTI progressed. By the time she reached the A&E, Liza’s temperature was 40.5°C. Sepsis had spread.
It’s anybody’s worst nightmare: going to hospital and winding up sicker. Yet healthcare-associated infections or HAIs—which develop as a direct result of medical or surgical intervention, or after contact with a healthcare facility—are common. A 2018 Europe-wide study by the European Centre for Disease Prevention and Control (ECDC) found that on any given day in 2016 and 2017, one in 15 hospital patients had one or more HAIs. Some 8.9m are contracted every year across Europe.
The most common are UTIs, pneumonia, surgical site infections, and gastrointestinal illness from bugs such as Clostridium difficile. Bloodstream infections—often introduced by invasive objects such as central-line catheters—are also major killers. Says Dr Carl Suetens, deputy programme coordinator for the ECDC, “The estimated burden of healthcare-associated infections is larger than the combined burden of all other infections under surveillance in Europe.”
Liza was given strong antibiotics and monitored as she recovered. She left hospital a week later. Now 37, she’s angry the hospital didn’t inform her of the known risks of catheters, or tell her about UTI symptoms or testing. She now campaigns for the Swedish Sepsisfonden, which raises awareness of sepsis.
A large proportion of HAIs could be picked up earlier, and many need never happen at all. Dr Diamantis Plachouras, senior expert for the ECDC, says, “We know from a recent literature review that 30 to 50 per cent of certain types of infections can be prevented.” Cracking down on these illnesses is at the core of patient safety.
“Things began to go awry”
Following the discovery of the antibiotic penicillin in 1928, doctors began to understand more about how bacteria spread. In 1941, the first-ever infection control officer was appointed at a hospital in the UK. Yet it still wasn’t a priority. Dr Jim Gray, a microbiologist at Birmingham Women's and Children’s Hospitals, says easy availability of antibiotics meant health workers felt relaxed as late as the 1980s. “They thought, Let the infection happen and we’ll treat it” he recalls. “And that’s when things began to go awry.”
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