"Everyday, 1.4 million people worldwide become victims of an NI. We could make a spectacular reduction in these numbers" (OMS Centre des Medias, November 10th, 2006).

Here in Quebec, one out of ten patients are afflicted by a nosocomial infection. This results in 90,000 victims and 4,000 deaths every year. On a daily basis, these figures translate to 240 victims and 11 deaths, surpassing the combined number of deaths caused by breast cancer, AIDS, and traffic accidents.

Over the past three years, two Quebec hospitals, the Centre Hospitalier Le Gardeur and the Centre Hospitalier Universitaire de Sherbrooke, have bucked this trend by clearly demonstrating that up to 80% of NI's can be avoided. Both hospitals graciously allowed us to publish their findings.

Centre Hospitalier Universitaire de Sherbrooke(CHU) - 700 beds
Between 2003 - 2004 and 2006 - 2007

• The number of SARM's (methicillin resistant staphylococcus) cases was reduced by 66%, from 245 (9.3 cases per 1000 admissions) to 84 (3.1 cases / 1000 admissions).
• C. Difficile cases fell from 350 (15.1 cases / 1000 admissions) to 61 (2.3 cases / 1000 admissions) for a reduction of 83%.

A SARM related nosocomial infection costs the health care system approximately $15,000 per patient, and prolongs an infected patients hospital stay by an average of fourteen days.

Preventative measures are ten times less costly, a mere $1,400 per patient.

Treatment costs for this specific infection were reduced over a three-year period from $3, 670,000 to $1,260,000. In other words, the hospital was able to save an impressive $2,415,000.

Moreover, the number of hospital days required to treat SARM related NI's dropped from 3,340 to 1,176. If we consider one hospital bed to be the equivalent of 300 days of hospitalization, then CHU saved 2,254 hospital days and 241 beds. These savings, in turn, can be used to reduce waiting lists and relieve pressure on emergency units.

Additional treatment costs related to C. Difficile are estimated at $10,000 to 12,000 per patient (J. Pepin et al. JAMA, August 13th, 2004). At CHU, additional costs for this particular NI fell from $3,600,000 - $4,320,000 to a mere $610,000 - $720,000 over a three-year period. This reduction generated savings of between $2,900,000 and $3,588,000.

In 2004, the Administrative Council invested $2,681,397 in measures to prevent NI's.


Centre Hospitalier Le Gardeur

In 2003, the Le Gardeur Hospital (250 beds) reinforced its hand cleanliness program in order to bolster the measures already implemented in 1998, 2000, and 2002.

Under the guidance of a special NI Prevention Team, a group of health care workers introduced a hand cleanliness program as well as a campaign to inform patients and visitors of the importance of washing their hands.

The number of SARM infections dropped by 88%, down from 108 in the years 2002 - 2003 (10.8 cases / 1000 admissions) to a mere 13 in 2005 - 2006 (1 case / 1000 admissions).

Due to the persistence of high infection and death rates (25 cases / 1000 admissions) caused by C. Difficile, preventative measures were buttressed by the systematic prescription of probiotics in conjunction with antibiotics.

Between February 2004 and August 2006, the total incidence of C. Difficile was reduced by 73%. In other words, the number of infections fell from 18.4 cases per 1000 admissions to 5 cases per 1000 admissions. The relapse rate was reduced by 30% and the death rate dropped from 10% to 1%.

In view of these facts, Quebecers have the right to wonder why some hospitals are able to ensure patient safety but not others.