Dr. J. Scott Weese likens veterinary medicine’s attitude toward infection control measures to where human medicine stood in the early 1970s, before the rapid spread of diseases like HIV.
Now with super bugs like Methicillin-resistant Staphylococcus aureus, or MRSA, on the scene, a solid infection control strategy is vital for veterinary practices, says Weese, an internist and microbiologist who heads infection control at the Ontario Veterinary College’s teaching hospital.
“It’s a very underdeveloped field,” Weese says. “Every veterinary clinic should have a formal infection control program.”
To drive that message home, Weese has co-authored what he says is the first set of routine guidelines meant for companion-animal practices. Titled “Infection Prevention and Control Best Practices for Small Animal Veterinary Clinics,” the 54-page report
sponsored by the Canadian Committee on Antibiotic Resistance touches on everything from hand washing to waste management.
“We’re looking at personal health as well as animal health,” Weese says. “People can easily acquire infection and bring it home and infect their families. There’s also owner safety. The paper addresses pretty broad topic areas.”
Dr. Craig Datz welcomes the approach, imagining that if practices do already have protocols, they’re probably buried in the bottom of a cabinet.
“There’s not been a scary disease like HIV to wake up the small animal practitioner,” says Datz, a clinician at the University of Missouri’s veterinary teaching hospital and an infectious disease and immunity consultant for the Veterinary Information Network. “Most of us don’t feel like we’ll catch diseases from our patients, but you can, if you’re not careful. MRSA makes you sit up and take notice.”
He adds that very little attention is paid to everyday protection against infectious diseases, even in teaching hospitals, where it can take a leptospirosis outbreak to get people on the safety bandwagon.
“A lot of situations like that could be better handled up front, even with simple hand washing, which is probably minimal in a lot of veterinary clinics,” Datz says.
The baseline of infection control is not rocket science and prevention strategies are far from cumbersome, Weese says. “But a lot of people spend a lot of time cleaning and disinfecting, and they don’t get anywhere because they’re not doing it right.”
To assure proper protocols are followed, the report suggests that practices name one person to be an infection control practitioner, or ICP, responsible for developing and implementing a safety manual and training veterinarians as well as other staff members. That central resource also would be charged with recording incidents of suspected hospital-associated infections.
Related audit tools allow practitioners to assess and evaluate their own infection-control standards.
The guidelines, designed to protect patients, owners, veterinary personnel and the community, also are meant to stave off legal cases. In the absence of an infection control program, it would be very difficult to argue that contracting a virulent staph infection like MRSA was not preventable, Weese contends.
“If there’s no demonstration that a clinic has gone the extra mile to make people aware and train people in infection control, I think that’s a huge liability,” he says. “A lot of clinics have kids working in them; training is very low. There is an inherent risk of injury and disease when working with animals, and that risk is big.”