Vineri, 16 11 2018
AKH Viena, o cloacă de infecţii comparativ cu Spitalul Hârlău

AKH Viena, o cloacă de infecţii comparativ cu Spitalul Hârlău

Cu chiu-cu vai, spitalele din Iaşi au recunoscut dublarea numărului de infecţii nosocomiale între 2010 şi 2016. Mulţi români cheltuie sume enorme pentru a se trata la celebru spital din Viena, neştiind că ar fi mai în siguranţă la Hârlău. În 2016, procentul de infecţii intraspitaliceşti la AKH a fost de 4,7, iar la Hârlău de 0,7%. Ordin de la minister: raportați corect infecțiile, managerii nu vor mai fi trași la răspundere. Deschiderea e însă un proces foarte timid.

 

Potrivit raportărilor făcute de spitalele ieşene în primul trimestru din 2017, procentul de infecţii nosocomiale este 1,16, cu mult sub valoarea existentă în realitate.

 

Spiridon: 1.313 cazuri în 15 luni

În perioada ianuarie-martie 2017, cele mai multe infecţii au fost semnalate de Spitalul „Sf. Spiridon“ – 249, raportat la un număr de 11.890 de pacienţi externaţi, rezultând un procent de 2,09%. Cel mai mare procent din judeţul Iaşi a fost înregistrat la Spitalul „Sf. Sava“, unde au fost înregistrate 12 cazuri de astfel de infecţii la un număr de 347 de pacienţi externaţi, adică 3,45%.

În 2016, fuseseră raportate în spitalele din Iaşi 2.359 de cazuri de infecţii nosocomiale, la un număr total de pacienţi externaţi de 237.493. Cele mai multe proveneau de la Spitalul „Sf. Spiridon“ – 1.064, raportat la un număr de 47.068 de pacienţi externaţi, rezultând un procent de 2,26%. Cel mai mare procent din judeţul Iaşi a fost înregistrat tot la Spitalul „Sf. Sava“, unde au fost înregistrate 45 cazuri de astfel de infecţii la un număr de 1.077 de pacienţi externaţi, adică 2,39%.

Spitalul Spitalul Clinic de Neurochirurgie „Prof. Dr. N. Oblu“ Iaşi a transmis la Direcţia de Sănătate Publică (DSP) informaţii despre 139 de cazuri de infecţii nosocomiale la 11.059 de pacienţi externaţi, în timp ce Spitalul de Copii „Sf. Maria“ Iaşi a raportat 214 cazuri la 27.951 de pacienţi externaţi, adică un procent de 0,76%.

 

Mulţi români spun că, la noi, intri în spital cu o boală şi ieşi cu mai multe

 

Paşcaniul şi Hârlăul, suspecte de fals

Surprinzător este faptul că incidenţa infecţiilor nosocomiale raportate la unele spitale vechi este sub cea de la Institutul Regional de Oncologie (IRO), unitate medicală nouă, în care s-au utilizat materiale antibacteriene moderne. La IRO, în 2016, a fost raportat un număr de 130 de cazuri de infecţii nosocomiale la 12.659 de pacienţi externaţi, adică un procent de 1,02%, în timp ce la Spitalul CFR Paşcani au fost raportate doar 4 cazuri la un număr de 3.442 de pacienţi externaţi, adică un procent de 0,11%. Cel puţin ciudate sunt şi datele furnizate de Spitalul Orăşenesc Hârlău, unde condiţiile igienico-sanitare sunt precare, şi unde s-au raportat doar 3 cazuri la un număr de 4.062 de pacienţi externaţi, adică un procent de 0,07%.

În primul trimestru din 2017, la IRO s-a raportat un procent de 1,61%, cu 49 de cazuri la 3.034 de pacienţi externaţi. Şi dacă la Spitalul CFR Paşcani numărul de cazuri raportate a crescut la 19, la un număr de 3.303 de pacienţi externaţi, adică un procent de 0,57%, la Spitalul Orăşenesc Hârlău nu s-a raportat niciun caz de infecţie nosocomială la un număr de 1.174 de pacienţi externaţi.

Fără infecţii nosocomiale s-au declarat, în primul trimestru din 2017, şi spitalele „Providenţa“, la un număr de 507 pacienţi externaţi, şi „Arcadia Cardio“, cu 960 de pacienţi externaţi. Directorul medical al Spitalului de Boli Infecţioase „Sf. Parascheva“, Mihnea Hurmuzache, consideră că astfel de raportări sunt total false: „Este imposibil ca la un spital din România să nu ai măcar un caz de infecţie nosocomială. Aşa ceva nu există!“

 

Dublu faţă de 2010

La o analiză a raportărilor făcute de spitalele ieşene privind numărul de infecţii nosocomiale, se observă o creştere destul de mare în 2015 şi 2016 faţă de anii anteriori. Ceea ce nu înseamnă, neapărat, o creştere a numărului de infecţii, ci a celor recunoscute în raportări. Astfel, în 2010, au fost raportate 1.154 de cazuri, în 2011 – 1.230, în 2012 – 1.568, în 2013 – 1.669, în 2014 – 1.761, în 2015 2.035 şi anul trecut – 2.359.

Dacă în perioada 2010-2014 procentul a fost de 0,65%-0,68%, în 2015 s-a ajuns la 0,82% şi 0,99% în 2016, oricum cu mult mai puţin decât situaţia reală din spitalele ieşene. Recunoaşterea unui număr mai mare de infecţii în spitale s-a datorat în ultimii doi ani şi controverselor din jurul tragediei din clubul bucureştean Colectiv, din octombrie 2015, scandalului „Hexi Pharma“, de anul trecut, dar şi cele mai recente declaraţii date de ministrul Sănătăţii, care a anunţat că raportările infecţiilor nsoocomiale nu vor influenţa evaluarea managerilor de spitale.

 

Nu raportează de frică

Medicul Mihnea Hurmuzache susţine că există multe cazuri care nu sunt raportate la DSP. „Raportările la noi sunt în continuare subdimensionate şi nu concordă cu ce se întâmplă în străinătate. În continuare, managerii şi medicii se consideră culpabili dacă declară cifra reală a infecţiilor nosocomiale şi nu înţeleg că nu sunt traşi la răspundere dacă declară corect. S-a spus clar de la minister că orice valoare între 1 şi 4% este normală. Nu înţeleg de unde această frică în a declara cifra corectă. Spitalele sunt medii deschise şi e normal să apară astfel de infecţii. În plus, există un program anual, prin care sunt alocate sume destul de importante pentru combaterea infecţiilor nosocomiale în spitale“, precizează Hurmuzache.

 

Stafie recunoaşte că infecţia intraspitalicească e o problemă

 

Spitale-santinelă

Directorul DSP Iaşi, Liviu Stafie, susţine că includerea a zece spitale din judeţul Iaşi în programul naţional de tip “santinelă” va duce la raportarea corectă a numărului de infecţii nosocomiale. „Prin acest program se doreşte un control al infecţiilor nosocomiale din unităţile medicale. Raportările se fac periodic, iar DSP le centralizează. Programul naţional de tip santinelă, iniţiat de minister, va duce cu siguranţă la o creştere a raportării numărului de infecţii nosocomiale şi la o apropierea de cifra corectă. În continuare, infecţia intraspitalicească a rămas o problema de sănătate în România, unde se observă încă o sub-raportare a acesteia“, a declarat Liviu Stafie.

 

Europa: Procent de peste 5

Potrivit statisticilor europene, infecţiile nosocomiale afectează între 5,1% şi 11,6% dintre pacienţi, media fiind de 7,1%. În Austria, spre exemplu, investiţiile majore în sistemul sanitar au dus la o scădere a infecţiilor din 2016 la 5%, faţă de 6,2% în 2012. De menţionat că Austria a fost primul stat european care a prezentat datele pe 2015 pe un protocol revizuit, mai exigent, al Organizaţiei pentru Cooperare şi Dezvoltare Economică.

La Spitalul AKH din Viena, al treilea ca mărime din lume, care are 2.200 de paturi şi 51 de săli de operaţie şi unde vin la tratament peste 1.000.000 de pacienţi anual, a fost anunţat pentru 2016 un procent de 4,7%.

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