History’s lessons on infection prevention

October 28, 2021

For our continued recognition of International Infection Prevention Week (Oct. 17-23, 2021), we wanted to share some of the history of infection prevention development. In 1847, Ignaz Semmelweis, an Austrian physician at a maternity hospital, noted a pathologist who cut himself with a scalpel died of the same disease as the corpse he was performing an autopsy on. He also noted that more women died whose babies were delivered by medical students who had just come from performing autopsies than by midwives who did not. He theorized that hands were contaminated and introduced chlorinated lime to be used for handwashing before patients were seen. This simple intervention drastically reduced mortality. Unfortunately, his theories were dismissed by the medical community for 50 years.

In the early 1900s scarlet fever swept through hospitals in the US. The use of antibiotics and improved hygiene practices are attributed for its decline. Within 3 years of this event, every hospital had an officer who worked with other staff and administration to reduce health care acquired infections (HAIs) in general. Negative bacilli became the most common HAI and broad-spectrum antibiotics were used for treatment. Unfortunately, this led to highly resistant strains of pseudomonas.

By the 1970s the CDC started gathering infection prevention and control (IPC) data to evaluate IPC practices. The Joint Commission issued requirements for data collection and surveillance for patient safety and quality improvement. But it wasn’t until the 1980s that complex efforts were initiated. Before this time, staff did not use gloves to start IV use or change dressings. The use of safety needles or needleless IV sets was nonexistent. Additionally, there was no emphasis on hand washing. Then came HIV and AIDS as well as hepatitis epidemics. Within a short time, the CDC, OSHA, and WHO all issued new recommendations for the health care setting improving IPC. One of the most important recommendations was OSHA’s Blood-borne Pathogens Standard, recommending PPE when there is any potential contact with blood or bodily fluids from any patient. Needle stick protection measures came out as well.

In 2003, the Joint Commission issued its first National Safety Goals which addressed the reduction of HAIs and recommended either CDC or WHO handwashing practices be followed and recommended that any death or disability secondary to HAIs be reported as a sentinel event. What did everyone’s efforts to improve IPC have in common with us today? They made their intention infection prevention, “Make your intention infection prevention” too!  (Story adapted from CDC (2013). Infection control in healthcare, an introduction: history of healthcare-associated infections. Infection Control in Healthcare. Cypress, CA.)


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