Hospital Infections

A trip to the hospital for surgery, or even an emergency visit, may put your life in greater danger than you realize. The latest killers in the United States are infections acquired in the hospital.

The federal Centers for Disease Control and Prevention projected this year that almost 5% of hospital patients will get an infection and that approximately 100,000 people will die from these infections. (Death from hospital infection is now linked to more losses than diabetes or Alzheimer’s disease.)

Hospitals can significantly reduce injuries and death from hospital acquired infections. The most basic measure available to hospitals is to prevent patients from becoming infected. Patients who are infected must be identified and isolated. Hospitals must maintain meticulous hygiene rules. By increasing their focus on prevention, hospitals can protect their healthier patients from those with dangerous infections.

MRSA, methicillin-resistant staphylococcus aureus is a particularly dangerous hospital acquired infection. Its resistance to a number of antibiotics can cause infections of surgical sites, the urinary tract, the bloodstream and the lungs, leading to serious illness or death.

MRSA can be brought into hospitals by patients who have no symptoms, and it then thrives in settings where immune systems are weakened and where openings to the body provide easy entry. It now accounts for 63% of hospital staphylococcus infections, which are up 22% since 1995.

The identification of patients with MRSA, isolation of patients with MRSA and for meticulous hygiene including the use of complete surface sanitation with alcohol is necessary to eliminate MRSA in areas where patients are recovering from invasive procedures.

Hospitals in Europe and in a few United States locations have implemented prevention programs that have been effective in protecting patients.

Facts About Hospital Acquired Infections

The problem

• There are 2 million hospital acquired infections (HAI’s) in the U.S. per year
• 100,000 deaths from HAI’s in the U.S. per year
• $20 billion is the estimated cost of treatment (1% of the nation’s health care budget)
• MRSA (methicillin resistant staph aureus), an infectious agent growing at an alarming rate, is difficult to treat.
• In 1974, MRSA accounted for 2% of the total number of staph infections; in 1995 it was 22%; in 2004 it was 63%

Hospital infections are largely preventable

• Many authorities agree that most hospital infections are preventable
• A hospital in Pittsburgh reduced it’s surgical infection rate by 78%
• Medicare now lists certain hospital infections as “preventable”
• Many European countries have reduced their infection rate (particularly of the most virulent strains) to almost zero

What hospitals should be doing

• Screen asymptomatic patients on admission –especially high risk patients
• Screen all health care workers
• Isolate infected patients and those who are carriers
• Enact policies to prevent health care workers from infecting patients
• Control antibiotic use to prevent resistant infections
• Clean all surfaces and instruments thoroughly
• Culture all surfaces routinely
• Identify high-risk procedures, locations in hospital, patients, etc.
• Educate hospital staff
• Enforce hand-washing rules strictly!
• Provide antibiotic soap dispensers in all corridors
• Increase infection control personnel in hospitals
• Require antiseptic shower of patients before surgery

Groups at highest risk

• Intensive Care Unit (ICU) patients
• Patients with invasive procedures -- catheters and IV’s
• Immune suppressed (e.g., cancer) patients
• Immunologically naïve (e.g., newborns) patients
• Surgical patients
• Patients with long hospital stays

What patients can do

• Request a nasal swab and culture on admission
• Ask the hospital about recent infection outbreaks
• Beware that consent forms will mention the risk of infection -- demand more information about the hospital’s infection rate
• Note the information (or lack of information) on the form
• Insist that all health care workers wash hands before treatment (use of gloves is not enough)
• Be aware of your hospital environment and sanitation procedures
• Avoid unnecessary invasive procedures
• Avoid overuse of antibiotics

Legal recourse

• Patients who suffer serious and life altering hospital-acquired infections should seek legal recourse
• Whether or not a lawsuit can be brought will depend upon the unique facts of the case
• Anyone aware of an outbreak should report it to an attorney