2nd World HAI Forum: Experts Discuss Looming Threats to Patient Safety

• Newly evolved enzymes make some bacteria resistant to all common antibiotics
• Healthcare workers slow to receive flu vaccines
• Countries not doing enough to combat “superbugs”

About 7 million Healthcare-Associated Infections (HAIs) in the U.S. and Europe each year

According to a meeting of over 60 infectious disease experts, the global medical community must act on three imminent threats to patients across the world. First threat: common bacteria, such as Escherichia coli (E. coli) are now producing enzymes which make the bacteria capable of inactivating all but the antibiotics that specialists reserve as a last line of defense. Second threat: healthcare workers themselves may be contributing to the spread of infections by failing to get flu vaccinations and, in some countries, coming to work when they are ill rather than taking sick days. Third threat: Health ministries are failing to adopt proven health policies that could limit the spread of infections in hospitals and other healthcare establishments.

The experts, meeting at the 2nd World HAI Forum, called upon health authorities and healthcare professionals worldwide to “reduce consumption of antibiotics and act as quickly as possible before some multi-drug resistant bacteria become endemic”. Many of the experts expressed concern that there is a false impression that HAIs are under control. With new kinds of bacterial resistance Klebsiella pneumoniae carbapenemases (KPCs) and new strains (PVL-positive Staphylococcus aureus) appearing, HAI are still a major public health threat.

During their discussions at the Fondation Mérieux Conference Center, the experts proposed “the bundling of preventive actions, which have proven to be effective in several countries, to fight against Methicillin resistant Staphylococcus aureus (MRSA): patient isolation, reinforced hygiene, screening and decolonization of carriers”. In some countries, more than 60% of S. aureus cases in hospital intensive care units are now resistant to first-line antibiotics.¹

Another topic at the Forum was influenza, which is also transmitted in hospitals and poses a risk for the most vulnerable patients, including the very young, the very old and immunocompromised patients. Citing the underestimation of this risk by healthcare professionals and their low vaccination rates, the experts are pushing for them to get vaccinated.

The participants also encouraged “local public reporting of HAIs by all hospitals in order to measure the success of prevention policies”.

“Bacteria know no borders and healthcare professionals around the world are facing the same challenges of increasingly complex and resistant microorganisms,” stated Alain Mérieux, President of bioMérieux. “By mobilizing the forces of some of the world’s leading experts in Infection Prevention and Control, it is our ambition to help the global healthcare community take concrete action to address this critical public health issue.”

According to Didier Pittet, Director of the Infection Control Program, University of Geneva Hospitals and Lead of the First Global Patient Safety Challenge, WHO World Alliance for Patient Safety, “The real global pandemic today is antibiotic resistance, which is a silent epidemic and a time-bomb because tomorrow, we won't have any effective antibiotics. Healthcare-associated infections are making this problem of resistance even worse: the world needs to wake up to this now and make fighting HAIs and the spread of resistance a priority in healthcare policies. This Forum is a unique place for exchange between international experts, and contributes to raising awareness about the seriousness of the situation - worldwide”.

Affecting at least 7 million people per year in the U.S. and Europe, healthcare-associated infections are now recognized as a critical public health issue and continue to be a major cause of morbidity, mortality and excess healthcare cost.^2,3 Their prevalence is continually rising due to increasingly sophisticated medical treatment and surgical procedures, international travel and the overuse or misuse of broad-spectrum antibiotics.

In the United States, HAIs affect approximately 1.7 million patients each year, resulting in 99,000 deaths² and an estimated $30 billion in healthcare costs.⁴

The 2nd World HAI Forum is an initiative of bioMérieux, a world leader in the field of in vitro diagnostics. bioMérieux is a partner with healthcare providers in implementing Infection Control policies to screen patients, manage outbreaks and monitor epidemiology.

To further promote the exchange of scientific knowledge and the development of a global HAI network, bioMérieux has, over the past two years, organized HAI-focused symposia in countries including the United States, Belgium, the Netherlands, Portugal, Spain, China and Japan. The 3rd World HAI Forum will be held in two years.

¹ Laxminarayan, R., A. Malani. Extending the Cure: Policy responses to the growing threat of antibiotic resistance. Washington, D.C, Resources for the Future 2007.
² Center for Disease Control and Prevention (CDC) figures 2007 - http://www.cdc.gov/ncidod/dhqp/hai.html
³ Suetens C. Healthcare associated infections in Europe : Burden and surveillance strategies, IPSE, 2006.
⁴ R. Douglas Scott II, Economist; The Direct Medical Costs of Healthcare-Associated Infections in U.S. Hospitals and the Benefits of Prevention - Centers for Disease Control and Prevention March 2009 - http://www.cdc.gov/ncidod/dhqp/pdf/Scott_CostPaper.pdf

About the World HAI Forum

The World HAI Forum brings together leading physicians and microbiologists in the field of Infection Control and Prevention from around the world. Held biennually, the Forum is a private initiative, independent from official organizations or authorities.

Its missions are to help guide and influence decision-makers by building awareness and understanding of healthcare-associated infections. At biennual meetings, Forum members examine current trends and data and engage in a lively scientific exchange about future challenges and actions to take, with the goal of anticipating how HAIs will evolve in the five years to come.

While most meetings focus on scientific developments retrospectively in an academic format, the World HAI Forum gives participating experts a chance to do prospective analysis of subjects that are not usually discussed. It also provides healthcare professionals with an opportunity to focus on success stories, best practices and to understand differences between countries.