Ask The Doctor Infection Prevention

Stephen M. Colodny, M.D.

Question: I’ve been reading a lot lately about hospital-acquired infections. What are the primary causes and are there any precautions my family and I can take to avoid these infections in the hospital?


Answer:  In 1847 Ignacz Semmelweis, a Hungarian physician working in Vienna, revolutionized hospital care by discovering that physicians were infecting mothers who had just given birth.  He further discovered that, if physicians wash their hands with a dilute chlorinated lime solution, they could decrease the incidence of these infections. Prior to that, mothers had a higher likelihood of dying during childbirth in a hospital than at home.

While the risk of hospital-acquired infections is still a reality even in 2011, hospitals, including St. Clair, have taken the approach that most, if not all, of these infections, can be prevented. In fact, St Clair is very proud of its results. The Hospital has decreased the incidence of certain infections to a rate that is near zero. Central line associated bacteremias (CLABS), or infections from large IV catheters used in the sickest patients have gone from 13 to one in the past five years.  Infections from urinary catheters and in patients on life-supporting breathing machines (ventilators) are near zero.

One particularly stubborn bacteria is Methicillin Resistant Staphylococcus Aureus or MRSA.  Prevalent in the community, it causes many different hospital-acquired infections, from pneumonia to wound infection, to infections in the blood stream. It is hard to treat, and can be fatal. Some hospital patients may have this bacteria on their skin before becoming sick with it, while, in others, it is brought to them by someone else, either directly, or by touching an object such as a doorknob, bedside table or elevator button, and then having someone else touch the same object such as a doorknob, bedside table or elevator button, that had previously been touched by someone infected with MRSA.  This bacteria can be anywhere in our environment, and is particularly present where there are lots of sick people, such as nursing homes.

Another very difficult problem is Clostridium difficile colitis ( C. Diff), a diarrheal illness that we usually see in patients who are receiving, or have recently received, antibiotics. It can cause anything from mild diarrhea to severe illness requiring removal of the colon or even death.
C. Diff can easily contaminate the environment and can be transmitted to others’ hands.

If you are in a hospital, you will notice there are some rooms with signs indicating isolation.   This means that staff members must wear gowns and gloves before entering, and must wash their hands when they leave. This is to prevent the spread of these and other bacteria. Unfortunately, some hospital visitors ― perhaps believing they are at no risk and are no risk to others ― do not wear the gown and gloves.

We are looking to residents of the community to help us make progress in fighting these difficult infections by following the same precautions we do, and by washing their hands before and after they interact with their loved ones. I’m confident that with the help of our strong community, and our continuous efforts, we’ll make progress on even the most stubborn hospital-acquired infections.

Stephen M. Colodny, M.D. earned his medical degree at New York Medical College in Valhalla, M.Y., completed his residency in Internal Medicine at Bayside Medical Center in Springfield, Mass. And completed a post-doctoral fellowship in factious disease at Yale-New Haven Hospital is New Haven, Conn.  He is board certified in internal medicine and infectious diseases.  Dr. Colodny is Chief of the Infectious Diseases Division at St. Clair Hospital and practices with Pittsburgh Infectious Diseases, Ltd.  Contact Information

This article is for informational purposes and is not intended to serve as medical advice.  Please consult your personal physician.

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