Risky Business
By Carol Shenold
Nosocomial.
Does that mean anything to you? It should. Hospitals hate the word. Doctors fear it, and an estimated five to ten percent of hospital patients in the U.S. (two million a year) develop the problem. The incidence of nosocomial infections and their cost to healthcare are such that the Centers for Disease Control follows the trend on a continuous basis.
A nosocomial infection is one that's acquired in a hospital or other medical facility. Especially at risk are people who are seriously ill or whose immune systems have been suppressed. These infections are made more dangerous now by the prevalence of drug-resistant bacteria, posing a major threat to everyone.
Guess what. Your pet could be at risk too. Even though veterinary medicine hasn't conducted many studies on this, based on anecdotal evidence, five percent of hospitalized animals develop a nosocomial infection, according to Janet King, B.S., C.V.T., an instructor at Belray Institute of Animal Technology in Denver.
Risk Factors
Many of the same risk factors will put both humans and animals in the path of infection. Nosocomial infections often occur in patients who are already ill, elderly or malnourished. Other risk factors are:
- extremes of age, young and old
- chronic debilitating disease
- hospitalization while on steroids
- chemotherapy (immunosuppressive)
- invasive diagnostic or medical procedures
- prolonged hospital stay
- lengthy surgical procedures (These infections may only occur in one percent of patients when surgery lasts less than 30 minutes but may jump to 14 percent if surgery lasts more than three and a half hours)
Overuse or improper use of antibiotics compound the problem. Parents often want an antibiotic every time their child sneezes. Many pet owners are the same. Those who don't follow directions-such as giving four days of a ten-day antibiotic prescription and then stopping because the animal seems better-also add to the problem. The few bacteria left can begin developing a resistance to that antibiotic, just as in humans.
The most common nosocomial problem areas are respiratory tract infections, surgical incision or wound infections and GI tract infections. Some of the most dangerous infections for pets include: brucellosis, leptospirosis, giardiasis, toxoplasmosis, staph, strep, e.coli, parvoviral diarrhea, rabies, salmonellosis and shigellosis.
Take action
The possibility of your animal developing such an infection may never have occurred to you. But now that you know, what do you do? First, make certain your pet is current on immunizations. The next option, if your pet is ill, is home care. Ask your vet.
Do research before your pet becomes ill enough for a hospital stay. Take time to check out your veterinary clinic's surgical and hospitalization facilities.
Ask questions. Be suspicious of a facility that reacts to questions with anger or evasion.
- Does the facility offer boarding services? If so, are there separate areas for the boarders and hospitalized population?
- How is the facility cleaned and monitored?
- Are there separate postoperative areas from the rest of the population?
- What are the visiting arrangements?
You won't be the only one evaluating the place. Just as the Joint Commission Accreditation for Healthcare Facilities oversees hospitals for humans, the AAHA has a certification process that provides answers for pet owners. To be certified, the veterinary hospital must have surgical and laboratory facilities and an isolation ward with 24-hour coverage. Seek out certified facilities. Avoid those where they're unhappy about your questions.
Tour the facility. If there are feces in the cages and dirty towels on the floor, there's greater chance of infection. More patients in smaller spaces increase risk. Are technicians cleaning tables and washing hands between patients, and wearing gloves to handle body fluids? These are basic precautions necessary for the prevention of cross-infection. These universal precautions should be used when caring for humans and animals. Hand washing is the single most effective prevention for the spread of infection.
Knowing about infection risks is only part of the equation. Prevention depends on locating facilities dedicated to providing quality care. You're in control of who cares for your pet.
Carol Shenold is a registered nurse and freelance writer. She has written for Cats Magazine, Home Life and Oklahoma Today. She does medical-technical writing and teaches writing for Francis Tuttle Vo-Tech.
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