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Hospital Acquired Infections in China

surgeon with mask

Hospitals around the world are facing a serious crisis: the spread of infection among patients. China is no exception.

Writing in prominent medical journals, Chinese scientists have called hospital-acquired infections “a prominent public health concern” and “a major problem for patient safety.”

“Wards have become breeding grounds for microbial pathogens.”

— Bingwei Sun, M.D., Ph.D., Hospital Infection Management Expert at Jiangsu University

Even more worrisome, many of these pathogens are antibiotic-resistant superbugs. Globally, 70% of bacteria have developed resistance to antibiotics, which makes infection treatment more difficult and expensive — and makes solutions more urgent.

The Scope of the Problem in China

In China, an estimated 5% to 10% of hospitalized patients contract infections while hospitalized (considerably improved by 2021), including about 17% of patients in intensive care units. Patients infected by a superbug spend many extra days in the hospital, costing China ¥10–¥15 billion each year.

“Hospital-acquired infections add to the workload of medical staff, cause huge economic losses to the patients, and affect the economic and social benefits provided by hospitals,” notes Wenlong He of Tianjin Medical University School of Public Health.

In recent years, Chinese health officials have committed to improving hospital infection control and increasing collaboration with the World Health Organization (WHO). Few have forgotten the 2003 outbreak of severe acute respiratory syndrome (SARS), which originated in China and spread to 19 countries.

The government is eager to protect its citizens from contracting and spreading viral and bacterial infections, and indeed, most hospital-acquired infections are preventable.

Education vs. Technology

Stopping this epidemic will require better hand hygiene, surface disinfection, and air disinfection — a combination of staff education and technological innovation:

  • The Education Front: Hospitals are working to better train doctors and nurses on infection-control practices. There is significant room for improvement: a survey of six Shanghai hospitals found “considerable shortcomings” in staff knowledge, where only 2.8% of surveyed doctors and nurses achieved a passing score on an anonymous questionnaire.
  • The Technology Front: Top hospitals are installing Novaerus air disinfection units, which not only kill airborne bacteria and viruses but also dramatically reduce chemical pollutants. Popular in hospitals throughout Europe, Novaerus technology is now available in China via Hangzhou Dao Cheng, a distributor with more than a decade of experience supplying medical equipment to public and private healthcare facilities.

This article discusses the state of infection control in Chinese hospitals and the solutions that can safeguard patients while reducing the severe economic burden borne by healthcare institutions.

How Infections Are Spread in Hospitals

On any given day, at least 1 in 31 patients in the United States has at least one healthcare-acquired infection, such as pneumonia, meningitis, colitis, gastroenteritis, peritonitis, or sepsis. In China, lower respiratory tract infections are the most common, according to a study of 52 Chinese hospitals, followed closely by urinary tract, upper respiratory tract, and surgical site infections.

According to a report on China's hospital infection control progress, the departments with the highest rates of healthcare-acquired infections include:

  • Surgical ICU
  • Hematology
  • Emergency
  • Respiratory Medicine
  • Neurology

However, patients anywhere in the facility are vulnerable. Twenty-four hours a day, pathogens accumulate and travel throughout the hospital via visitors, staff, and medical equipment. The web of transmission routes is vast, complex, and invisible — 1,000 dangerous germs could line up across the top of a pencil eraser without being seen. Because we can’t see them, it is easy to forget they are there.

👉 Learn more about what's in the air.

Common Transmission Vectors

  • Airborne Aerosols: Viral particles launched by a sneeze — or even by changing bed linens — can hover in the air to be inhaled by patients or settle on IV poles, wheelchairs, and stethoscopes.
  • Cross-Contamination: Pathogens deposited into a box of surgical gloves can hitch a ride via central line to a patient’s bloodstream, or via catheter to the urinary tract.
  • Surface-to-Hand Transfer: Bacteria can travel from an infected patient's bed rail to a nurse's hands and quickly spread to vulnerable patients during routine care.
  • Routine Physical Contact: Lethal microbes can flourish on intact skin; healthcare workers’ hands can become contaminated after seemingly “clean” procedures like taking a pulse or temperature, as well as higher-risk tasks like dressing wounds or managing ventilators.
  • Equipment & Apparel: Humidifiers, supply carts, stretchers, glucometers, computers, and even a doctor’s white coat serve as vectors for pathogen transmission.

Despite these risks, transmission routes may not always be top of mind for hospital staff. As a report on Shanghai hospitals noted, “Clinicians casually consider healthcare-associated infections as a specialty belonging to infection specialists who should be responsible for management, thereby getting away from responsible conduct and liability.”

👉 Read Part 2: Three Strategies for Reducing Hospital-Acquired Infection