The Microbiopolitics of Human-Microbe Relationships: Hospital-Acquired Infection Control in Latvia

Despite infection control being a quintessential element of biomedicine, the problem of hospital-acquired infections (HAIs) is the most common patient safety problem worldwide. Regardless of the high priority on the global health agenda, evidence shows suboptimal results in terms of providing safe healthcare, free from these infections. Healthcare and research responses have focused upon behaviour change of medical personnel and organisational barriers/facilitators to address the gap between how HAI control should and is done.

The research aims to understand the phenomenon of HAI control, by looking at how it is negotiated and navigated within and between different settings and people in Latvia. I achieved this by utilising a conceptual framework of the microbiopolitics of human-microbe relationships and multi-sited ethnographic approach to trace HAI control through media, policy, and hospital settings. In this study, I have offered a recalibration of the HAI problem: instead of scrutinising the imperative of insufficient HAI control, I have steered my research towards ethnographically examining the phenomena of HAI control itself and how it is assembled in the first place.

The study reveals that process of achieving germ-free and safe healthcare goes far beyond the individual and isolated behaviour of compliance and non-compliance with HAI control requirements. Instead, research illustrates the phenomenon of HAI control has local and historical embeddedness and it is an instance of dynamic epistemic and socio-material assemblages of human and non-human entities. The study therefore demonstrates that context- and situational-dependent recognition and understanding of microbes and management of microbial encounters manifest in different approaches to HAI control. Moreover, achieving HAI control not only depends on levels of compliance with HAI control policy but also on the quality of policy itself. As study revealed, HAI control can not only produce recognition and management of HAI risks but also spaces of neglect and exclusion.