Ministry of Health’s report finds irregularities in Romanian hospitals that treated Colectiv club fire victims

A media investigation showed at the beginning of December thatmany of the people who died after the Colectiv club tragedy in Bucharest have been killed by aggressive germ infections they developed in the Romanian hospitals. The Romanian Ministry of Health has recently completed a report on hospital infections at the medical facilities where the Colectiv club fire victims have been admitted. The report shows that some of the patients have been infected with antibiotic-resistant bacteria and that some hospitals didn’t have the tools to detect the presence of these bacteria. According to the report, all the hospitals respected the rules of hygiene, disinfection, and waste management. The document shows a small degree of hospital infections for November. The incidence of infections varies between 0% and 0.8% in most of the hospitals that treated the victims of the club fire, the Burns Hospital registering the highest level of 2.8%. However, in most cases, the appropriate treatment of hospital infections led to a positive development, according to the Ministry of Health. Most deaths were registered in the patients who had severe lung injuries that increase the risk of mortality by 8-10 times. Some of the hospitals couldn’t isolate the Colectiv club victims from other patients. Thus, only six of the 11 hospitals were able to isolate patients in intensive treatment units (ATI). Moreover, eight of the hospitals can provide microbiological diagnosis 24/7 while four of the evaluated hospitals don’t have their own lab. “The methods to determine the bacteria’s resistance to antibiotics and the rules of interpretation of this resistance are variable and sometimes out of date,” according to the Ministry of Health. The report also shows that only seven of the 11 evaluated hospitals were able to provide medical and special auxiliary staff dedicated to burns patients, without being able to ensure separate staff for each group of patients colonized or infected with a particular microorganism with epidemiologic risk. The lack of personnel was the primary reason for this situation. Taking into account the answers to the questionnaires and the talks with representatives of hospitals, the Ministry concluded that not all the hospitals had the capacity to control the movement of germs in the medical units, and the current equipment of labs and/or their outsourcing didn’t allow an efficient control of infections or monitoring of antibiotic therapy in all the hospitals. Moreover, the Ministry found that there was no uniform approach, based on protocols, in some sensitive activities such as screening, isolation of patients, and cleaning/disinfection based on the area of risk. Although there were many protocols, part of the stuff didn’t know them, or failed to respect the rules. This reflects the need of a thorough training. Hospitals lack the required specialized staff in the control and prevention of hospital infections, or the staff is insufficient, according to the report’s conclusions. Moreover, the dedicated nursing staff (for 1-2 critic patients) is more than insufficient, which leads to a higher risk of infection. Following these results, the Ministry of Health has ordered the development of a national action plan with clear objectives in the short, medium, and long term. On the short term, the plan includes the setting up a control group. 23 club fire victims are still admitted in hospitals in Bucharest and abroad. 4 of them are treated in Bucharest hospitals, while the rest are admitted in clinics in Austria, Belgium, the Netherlands, Germany, the UK, and Israel.