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Hospital-Acquired Infection…and What To Do About It

Posted by medconsumers on February 1, 2008

What kills more than five times as many Americans as AIDS? Betsy McCaughey, PhD, chairman and founder of the Committee to Reduce Infection Deaths (RID) wants you to know that it is hospital infections, specifically a bacterium called methicillin-resistant Staphylococcus aureus. MRSA infections are far more difficult to treat than ordinary Staph infections because they are resistant to most types of antibiotics.

Dr. McCaughey, former lieutenant governor of New York State, has made it her mission to get hospitals and especially the Centers for Disease Control and Prevention (CDC) to make prevention a high priority. In a recent Wall Street Journal op-ed article, she notes, “These infections are caused largely by unclean hands, inadequately cleaned equipment, and contaminated clothing that allow bacteria to spread from patient to patient. At one time, hospitals routinely tested surfaces for bacteria, but in 1970, the CDC and the American Hospital Association advised them to stop, saying testing was unnecessary. Astoundingly, the CDC still adheres to that position despite a 32-fold increase in MRSA infections.”

Dr. McCaughey is interviewed by Maryann Napoli, Center for Medical Consumers.

MN: The statistic that you use—100,000 deaths due to hospital infections annually in the U.S.—comes from the CDC, doesn’t it?

BM: The CDC is only one source. Their more recent statistic is: One out of every 10 to 20 people contracts an infection [while in the hospital]. The CDC puts the number of deaths at 99,000, but other sources say that is a severe undercount. So I usually say, “At least 100,000 deaths.” In fact it’s probably quite a bit more.

MN: What is your basis for saying that?

BM: Last October the Journal of the American Medical Association published a study about the extent of the MSRA infections in U.S. hospitals that nearly doubled what the CDC had been estimating. The reason is the methodology used. Instead of relying on what hospitals report or tell patients’ families, these new data are based on laboratory results which cannot be diminished or modified.

MN: Explain that.

BM: When the hospitals send all their tests to the labs, the laboratories simply count, “How many MSRA infections do we have here?” This was the first nationwide study using this methodology on the extent of MSRA—85% of which occurred in hospitals. The CDC realized that the extent of MSRA infections is far larger than what hospitals had been reporting. And if that’s true for MSRA infections, then it’s likely true for other types of bacteria. So the previous CDC guesstimates need to be reevaluated, based on this October 17 study in JAMA. It revealed the truth gap in the previous methodology.

MN: Denmark, Finland and the Netherlands reduced their soaring rates of MRSA infections to near eradication with multiple preventive measures (see “15 steps” at Dr. McCaughey’s Web Site). You are very critical of the CDC for not encouraging similar actions.

BM:
For 25 years, the CDC has tracked the rapid rise in drug-resistant infections. They have consistently understated the extent and cost of the problem. And they have done too little to prevent it.

MN: How do you explain the CDC inaction?

BM: I can only imagine, but having been in government, I know that often agencies that are created to oversee an industry become co-opted by the industry. They spend so much time with hospital administrators rather than with grieving families and ill patients that they begin to share the hospitals’ concerns about the difficulties of changing procedures, the difficulties of more effective cleaning.

MN:
You’ve been known to take cleaning matters into your own hands when friends or relatives are hospitalized.

BM: I’ve often gone into the hospital to visit a patient with a bag of cleaning supplies, including gloves, and cleaned the bed rails, the over-the-bed table, the TV monitor. I do it myself, knowing that otherwise it would not be clean.

MN: What do you use?

BM: Something like Windex [ammonia] because it has to stay on the surface for three minutes to kill the germs. It’s not a quick spray and wipe; it’s a drench and wait. Spray it on, wait three minutes to kill the germs and then wipe it off. The only one that Windex won’t kill is Clostridium difficile [bacterium that attacks the colon]—there you need something with bleach in it generally.

MN: We’ve been told that, when hospitalized, we should tell the hospital staff to wash their hands before touching us, but that’s difficult when you’re the one in the bed.

BM:
Generally it’s the families [that should do it] because patients are usually too sick, too scared, too old, or in too much pain to act on their own behalf. Families should not be worried about being too aggressive when their loved one’s life is at stake.

For more information:

See 15 steps you can take to reduce your risk of a hospital-acquired infection at the Web site of Dr. McCaughey’s Committee to Reduce Hospital Infection Deaths (www.hospitalinfection.org).

Consumers Union (www.consumersunion.org/campaigns/stophospitalinfections/learn.html) for ways to take action and articles on the topic.

The Leapfrog Group (www.leapfroggroup.org) is aimed at reducing medical mistakes, including hospital infections. See whether the hospitals in your area have instituted 30 safe practices of which five are related to healthcare associated infections. The hospitals collect and submit their own data. The Leapfrog Group does not independently verify the data.

Maryann Napoli, Center for Medical Consumers ©
February 2008

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