A quiet hospital ward, a room prepared with a bed and an infusion stand
A prepared room: infection prevention begins at admission

A planned operation, a course of chemotherapy, a few days on a medical ward… and then, when nothing seemed to suggest it would happen, an infection appears. It wasn't there on admission. This is exactly what is now called a healthcare-associated infection — the term that has replaced 'nosocomial infection' in official language.

Some multidrug-resistant organisms, including MRSA, are falling clearly. That decline, real as it is, doesn't exempt you from the simplest step of all — washing your hands.

What exactly are we talking about?

A healthcare-associated infection shows up during or after care. That applies to hospitals, private hospitals and care homes, but also to the home when nursing care is provided there. The most common sites are still the lungs, urinary tract and surgical wounds.

On the bacteria front, three names come up regularly in analyses: Escherichia coli, Pseudomonas aeruginosa and Staphylococcus aureus. Meticillin-resistant Staphylococcus aureus — the famous MRSA — is precisely the one that has fallen most clearly in France over the past 15 years or so.

A Petri dish with bacterial cultures held in front of a laboratory bench
Escherichia coli, one of the three names that come up in analyses

What the data show

The 2017 national prevalence survey published by the French public health agency Santé publique France estimated that around 5% of hospital patients had a healthcare-associated infection on the day of the survey — about one person in twenty. This level was broadly stable compared with previous surveys, while some multidrug-resistant organisms, including MRSA, continued to fall. Current data therefore suggest that successive prevention plans have helped reduce some multidrug-resistant organisms, without resolving the issue.

Two useful clarifications to understand who does what. First, the Institut de veille sanitaire was merged into Santé publique France in 2016: it is now this agency that leads surveillance. Second, the French Ministry of Health set out a national programme for the prevention of infections and antimicrobial resistance for 2022-2025. Surveillance of infections linked to invasive devices — catheters, urinary catheters and intubation tubes — relies on the SPIADI network, set up in 2018, which took over from RAISIN.

Epidemiological surveillance graphs on a bright desk
In France, infection surveillance is led by Santé publique France

In practice, the steps that make a difference

  • Alcohol-based hand rub. Palm to palm, between the fingers, thumbs and fingertips, until the hands are dry. Before and after every contact with a patient; for visitors, on entering and leaving the ward.
  • Don't 'tinker' with a dressing, infusion or catheter. These tasks are for healthcare staff, with precise aseptic rules.
  • Speak up. A fever, diarrhoea, a cough or a wound that is weeping: reporting it lets the team adapt your care, even if it means postponing a planned procedure.
  • Antibiotics, only on prescription. Finish the prescribed course, and never reuse an opened pack — overuse feeds exactly the multidrug-resistant bacteria we are trying to slow.

For your own situation, the care team or your GP decides. What you can do on your side is ask the question, without worrying about being a nuisance.

Key points. A fever, burning when you urinate, redness around a catheter or a wound that is weeping in the days after a hospital stay should not be dismissed as normal. Contact the ward or department that cared for you, or your GP, promptly: the earlier a healthcare-associated infection is spotted, the more straightforward it is to treat.

A gloved nurse placing a sterile dressing over a catheter site
Dressings and catheters shouldn't be tinkered with; these tasks are for healthcare staff

Budget

The topic involves few purchases, but hand hygiene at home is one of them. A 100-250 ml bottle of alcohol-based hand sanitiser typically costs around £2-£5 in a pharmacy, health and beauty retailer or supermarket. A one-litre refill is usually about £5-£12, which is much better value in use. A standard mild soap is around £1-£4.

Worth knowing: no 'natural' alternative matches the effectiveness of an alcohol-based hand rub for disinfecting hands. Mild soap, in a bar or a refillable bottle, is for washing, not disinfecting — useful day to day, but not the same job. Prices vary by format, whether moisturising agents are included, and where you buy: pharmacy, supermarket or online.

Sources

  • Santé publique France — national prevalence survey of healthcare-associated infections (2017 edition) and surveillance reports.
  • French Ministry of Health — National programme for the prevention of infections and antimicrobial resistance 2022-2025.
  • World Health Organization — recommendations on hand hygiene and World Hand Hygiene Day on 5 May.
  • European Centre for Disease Prevention and Control (ECDC) — European surveillance of antimicrobial resistance.
  • Haute Autorité de Santé (HAS) — work and recommendations on the prevention of healthcare-associated infections.