Karolina Matracka, Global Sales and Marketing Director, Enbio Group AG shares that establishing stringent government-level guidelines for sterilisation and sanitation practices is essential, but it must be accompanied by behavioral interventions and systemic (technological) changes
Despite remarkable advances in medical treatments that have pushed the boundaries of healthcare, hospitals, clinics, and healthcare professionals across India continue to grapple with a silent yet deadly adversary—Hospital Acquired Infections (HAI). These infections, which often spread during medical treatment, have led to an alarming increase in patient mortality rates. HAI occurs in a patient during the process of care in a hospital or other HCF, which was not present or incubating at the time of admission. Experts in the field of microbiology and healthcare have raised their concerns, shedding light on the dire need for comprehensive reforms in infection management within the Indian healthcare system.
The latest statistics reveal a shocking reality: a staggering 30 per cent surge in the mortality rate within Indian hospitals is directly attributable to inadequate infection management. The crux of the problem lies in the lack of proper sterilisation facilities within healthcare institutions. Surgical instruments used in operation theaters, procedure rooms, and patient wards often fall short of the necessary standards for sterilisation and sanitation, posing grave risks to patients.
Infection management is an integral part of healthcare, and it demands immediate attention. Research unequivocally highlights the urgent need for a systematic overhaul of sterilisation and sanitation practices within Indian healthcare facilities. Recent comprehensive studies conducted by the National Center for Biological Information have revealed alarming deficiencies in infection management across both government and private hospitals. The National Medical Commission, drawing upon the findings of this study, has attributed the surge in mortality rates to infections acquired within healthcare facilities.
According to the World Health Organization (WHO) 7 to 10 per cent of every 100 hospitalised patients, 7 per cent in high-income countries and 10 per cent in low-middle income countries acquire at least one HAI. This percentage is higher in low and middle-income countries like India (Nearly 10 per cent), where inadequate resources, insufficient processes, lack of mandatory regulations, and underreporting exacerbate the problem. In reality, the approximately 30 per cent increase in the mortality rate in hospitals can be attributed to poor infection management. In most cases, hospitals have inadequate sterilisation facilities. As a result, the surgical instruments used in operation theaters, procedure rooms, and patient wards are not completely sterilised and sanitised, posing a significant risk to patients.
The main cause of HCAI transmission to patients in Indian hospitals is poor sterilisation and sanitation practices. Indian Ministry of Health and Family Welfare’s National Guidelines for IPC in HCF says “A new, serviced and repaired equipment or equipment that has been in contact with a patient should be cleaned, disinfected or sterilized as appropriate to prevent transfer of microorganisms to other patients and the environment.” These guidelines extensively address HAI protocols; however, there is currently no infrastructure in place that legally requires hospitals to practice and report infection control outcomes. Additionally, previous legislation such as the Clinical Establishments (Registration and Regulation) Act of 2010, has only been adopted at the state level of the legislature and is not mandated at the national level. Hence, there is an urgent need for regulations and policies pertaining to infection control.
Technology can play a critical role in containing HAI. The adoption of advanced medical sterilisation autoclaves has come as an effective measure. Medical B-class autoclaves are globally acknowledged as the gold standard for sterilisation in healthcare. They employ high-pressure steam and vacuum technology to effectively sterilise medical instruments, equipment, and materials, targeting resilient pathogens like bacteria, viruses, and fungi, thus reducing healthcare-associated infection risks. However, the uneven utilisation of proper medical B Class autoclaves in Indian PHCs poses significant concerns. Outdated and less efficient sterilisation methods are still in use in some centers, endangering patients and healthcare providers alike. This issue demands immediate attention from healthcare authorities, policymakers, and the community.
The consequences of subpar sterilisation practices are severe, resulting in preventable infections for patients, extended hospital stays, complications, and even loss of life. Healthcare providers also face elevated risks of exposure to infectious agents, impacting both their well-being and their ability to deliver quality care.
To combat HAI effectively, it is critical that the national government mandate hospitals to maintain accreditation licenses that are rigorously regulated by the existing National Accreditation Board for Hospitals and Healthcare Providers (NABH). Currently, only 714 hospitals are accredited by NABH, a stark minority when compared to the vast number of healthcare facilities across India.
The HAI crisis requires coordinated efforts at both the national and local levels. Establishing stringent government-level guidelines for sterilisation and sanitation practices is essential, but it must be accompanied by behavioral interventions and systemic (technological) changes. Only through collective action can India hope to protect the lives of its citizens and improve the overall quality of healthcare in the country.