From Epidemics to Cleanliness: The Development of Infection Prevention and Control and Disinfection over the Course of History
As part of the anniversary event, we asked two experts to give keynote speeches, looking not only at the history of infection prevention and control (IPC) and disinfection, but above all at the future. Dr Philipp Osten of the Institute for the History and Ethics of Medicine at the UKE traced the history of IPC and disinfection from the plague in the 14th century to cholera in Hamburg in the 19th century and the 1920s.
According to the medical historian, the year 1348 must be seen as a turning point in the history of IPC. That was when the port city of Venice set up a health administration in response to the "black plague", which had spread to Europe as a result of increasing global trade. "For the first time, doctors were publicly employed to detect, predict and contain diseases," says Prof. Dr Philipp Osten.
The containment measures introduced at that time to control the disease also gave rise to the common English term for a passport: passport. In the original sense, it was a written permit issued by the port authorities to leave the port after quarantine. In English: "to pass from port". In the centuries that followed, however, it was not common practice to do much more than isolate those who were actually or possibly ill - and to burn the dead and their belongings. After all, the actual cause of the plague was not known.
Fear of bacteria & disinfection
The treatment of diseases such as plague, cholera and the like would only change once the idea of tiny, invisible germs as the cause of these diseases was generally accepted. This was not a matter of course, as the cholera outbreaks in Hamburg in the 19th century show. In general, Hamburg was not a model of health management at the time: "The last major cholera epidemic in Europe took place in Hamburg," says Prof Dr Philipp Osten. One reason for this was that the Hanseatic city still believed that cholera was caused by vapours from the soil and not by contaminated drinking water.
According to Prof. Dr. Philipp Osten, this only changed in 1894 when the Imperial Health Office published a map of cholera deaths in and around Hamburg - and the result was striking: the number of deaths changed dramatically at the city limits. At the time, Hamburg's drinking water came directly from the river Elbe. In Altona, people were already drinking water filtered through sand. From then on, the idea of pathogens - the germ theory - took hold. With consequences: The fear of bacteria spread. The age of disinfection began with the "germ". "The fear of epidemics became an economic advantage," says Professor Philipp Osten. It became a competitive advantage for a port city to be able to offer a "safe harbour " that was not a gateway for new pathogens. The first disinfectant factories were established in the 1890s, mainly in port cities. The Sanders Bacillol factory was founded in Hamburg in 1897 and became the Bacillolfabrik Dr. Bode & Co. in 1924. The new era of port infection prevention and control was illustrated by a photograph from the time, presented by Prof. Dr. Philipp Osten: it shows "the guarding of a ship's cargo suspected of being infected with the plague by dogs as sharp as rats".
How can AI improve hospital infection prevention and control?
In the future, sharp dogs may no longer be needed to prevent infections. In any case, a sharp mind and a pragmatic, realistic approach: "Get out of the ivory tower! - Challenges and Future Perspectives for Practical Hospital Hygiene" was the title Prof Dr Johannes Knobloch chose for his lecture. The Head of the Department for Infection Prevention and Control (IPC) - Institute of Medical Microbiology, Virology and Hygiene at the UKE, focused on the extent to which artificial intelligence (AI) can help to improve infection prevention and patient safety.
The IPC specialist advocated a middle course between generalised prevention measures - i.e. "one size fits all" - and measures that are adapted as far as possible to the actual risk situation on site in terms of scope and implementation. Cost pressures in the healthcare sector alone make such an approach necessary. "Standard precaution measures are the standards that should be applied to all patients in the future," says Johannes Knobloch. However, measures that go beyond standard precautions should be individualised in the future. According to the IPC specialist, AI can provide valuable assistance in assessing infection risks and selecting appropriate infection prevention measures. Its advantage over human hygiene teams: AI is available 24/7!
More research for better data
But for AI to be useful, the algorithms need to be able to learn from good data. The prerequisite: Infections and all relevant data must be recorded correctly and automatically in hospital information systems! "The goal is an evidence-based risk assessment based on real data," says Johannes Knobloch. However, many of the measures currently recommended are opinion-driven and need to be scrutinised for evidence. "Based on insufficiently specific publications and data, AI is currently not very suitable as a concrete decision-making tool". Future tasks for IPC teams will include analysing the effectiveness of interventions and assessing technical and procedural risks. "The use of AI will massively change IPC teams in the future". According to Johannes Knobloch, new professional groups such as IT specialists will have to become part of such teams. Finally, the IPC specialist left the audience with a take-home message: "We now need to think about how AI can be integrated into everyday working life."
100 years of BODE Chemie GmbH: a century full of challenges, growth, innovation and, above all, the support of people who have accompanied us along the way. The coming years promise to be just as exciting as the last 100.
Find out more at: https://www.bode-chemie.com/en/company/history
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