Elevating Sterile Processing Businesses Through Tailored Consulting Excellence
see a small percentage of exogenous HAIs. The majority of HAI have an endogenous origin. Of course, it is still necessary to focus on basic or standard infection-control measures to prevent transmission of micro-organisms. However, the majority of HAIs have an endogenous origin now. Thus, our measures should not only focus on preventing transmission of microorganisms, but also on prevention of infections. Therefore, a personalized infection prevention approach is now appropriate.”
Sax pointed to a hand hygiene paradox.“ When we don’ t perform hand hygiene, we give patients infections, so we try to understand what the situation is when hands transfer pathogens and that drives HAI rates. Pathogens are everywhere. Microbial transfer is the norm. We have as many bacteria as we have cells in our body, and the exchange of microbes between human beings living together is a huge number, which could make for a richer microbiome and present positive implications for health.”
Sax continued,“ The issue is that people confound the issue, evwen in scientific papers, and call the colonization after a transfer an infection and don’ t make the distinction between just enriching your microbiome by more bacteria from actually having an infection, which is a bad outcome. So, one of the clear situations when you get an infection is by having a pathogen transferred to you and this microbe is very virulent so, you don’ t have a defense against it and you get infected. If this happens in a healthcare setting, it’ s usually because of an outbreak. The number of pathogens will increase. Or there might be silent outbreaks where pathogens
circulate in the hospital but don’ t show up because they are not multidrug-resistant and they don’ t increase the rate of infection. That’ s what I call the‘ new kid on the block’ – you have Staph aureus in your body and then you receive a new staph bacterium but your immune system is not primed for that, it’ s a new germ, so it might create a situation where you get infected despite having the same type of bacteria already in your body. The third situation is that when they test the microbiome and look for bacteria in your body, you find the bacteria already there before the infections occurs; but actually, these bacteria were acquired during the hospital stay a bit early and then incubated and then created the infection. But this is only valid if there is an infectious advantage. If you receive a new pathogen that is a multidrug-resistant bacterium and then you receive antibiotics that kill your shielding microbiome, this pathogen can thrive and create an infection.”
Sax continued,“ So, my conclusion is that we have high rates of endogenous bacterial transmission but we should not say in general that the invasive procedure spread in the hospital – HAIs don’ t spread, and HAIs are not per se a transmissible disease. So, hand hygiene is not the most effective prevention measure; it is a single intervention and is the singlular most effective HAI prevention measure, because there are multiple interventions that should be done in the healthcare setting. Don’ t invest in hand hygiene alone and expect your infection rates to decrease, but you should invest in hand hygiene to prevent the spread of multidrug-resistant genes – I think antimicrobial and antibiotic stewardship campaigns
The problems are still the same and that is the rapid spread of microorganisms.”— Dr. Jean-Yves Maillard
Guiding Excellence, Redefining Operations
Elevating Sterile Processing Businesses Through Tailored Consulting Excellence
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nov-dec 2025 • www. healthcarehygienemagazine. com •
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