Hospitals-- A Place People Go To Get Even Sicker?

I'm sure many people think of hospitals as places to go to be cured of sickness. I always think of hospitals as places to go to die. And not just to die because medicine doesn't cure much of anything but die because hospitals all filled with disease so that patients who go to them are at risk of catching something unrelated to whatever brought them there in the first place-- and dying. Does that sound crazy?

Thursday Reuters published a report from London that over 3 million Europeans come down with just such an infection in a hospital every year! That's 80,000 people a day, every day. And some of these infections are fatal or can take months of expensive and intense treatment to overcome. One in 18 patients in any given hospital at any given time has something he acquired in the hospital. "Healthcare-associated infections pose a major public health problem and a threat to European patients," said Marc Sprenger, director of the Stockholm-based European Centre for Diseases Prevention and Control (ECDC).

The most common types of infection are respiratory tract infections such as pneumonia and infections of the bloodstream. These are often caused by Klebsiella pneumonia and E. coli bacteria, both of which have shown an ability to develop resistance to some of the most powerful antibiotics.

Among a total 15,000 reported healthcare-associated infections, surgical site infections and urinary tract infections are also common. Many of the infections are also found to be drug-resistant "superbugs," the survey showed.

Among all infections with Staphylococcus aureus bacteria in which full testing was carried out, more than 40 percent were reported as resistant to methicillin-- in other words they were MRSA infections, the ECDC said.

Worldwide, MRSA infects an estimated 53 million people annually and costs more than $20 billion a year to treat. It kills around 20,000 people a year in the United States and a similar number in Europe.

EU health and consumer affairs commissioner Paola Testori Coggi said the findings of the European survey were "worrying" and urged health authorities to do more to protect patients in hospital and to step up the fight against antibiotic resistance.

Drug resistance is driven by the misuse and overuse of antibiotics, which encourages bacteria to develop new ways of overcoming them.

Experts say hospitals are often guilty of overusing antibiotics, giving them as "blanket" treatments before full testing has established which drugs are really needed.

That tendency to over-use antibiotics is even worse among American doctors. In fact in the U.S. hospital-acquired infections cost over $25 billion a year. A report from CBS News last month pointed out that one of the problems with hospital-acquired infection is not just that they can be deadly, they can also take a long time to diagnose. American doctors are hopelessly bad, notoriously so, at diagnosing anything that they didn't learn about in Med School.

One of the major problems is that bacteria found in hospitals has been evolving for generations. These organisms are subjected to antibiotics and disinfectants constantly, so those that survive are considered superbugs.

"These hospital-acquired infections are typically driven by bacteria, and bacteria are living organisms," Accelerate Diagnostics CEO Lawrence Mehren said on CBS This Morning: Saturday. "Like all living organisms, they try to survive and bacteria living in hospitals are living in a high threat environment."

Mehren says that you should not blame the institutions, that they are in fact very clean and that it is really about the biology of the bacteria.

Accelerate Diagnostics, a Tucson, Ariz., biotech firm, has come up with a way to more quickly diagnose these organisms for quicker treatment options. The firm developed a non-cultured testing for the rapid identification of drug-resistant organisms and hospital-acquired infections.

Thursday, the Toronto Star looked at some ways hospitals have been fighting back against this plague, beyond just washing your hands, which is what most older doctors tell you to do.

Progress is being made by hospitals to prevent infections from all causes and specifically from superbugs. You can always ask about a hospital’s infection rate, both overall and within each department. You also can ask about the technology used to avoid infections. Here’s what’s new and tried-and-true.

There’s ever-improving older technology. Ultraviolet (UV) germicidal technology continues to be upgraded and is used for sterilizing operating rooms, air ducts, hospital equipment, hallways and patient rooms. And steam/vacuum sterilization (by autoclaving for instruments) and the use of germicides are effective.

New stuff includes robotlike devices that can clean a room by dispersing hydrogen peroxide into the air and then detoxifying it. Some hospitals say this can reduce a patient’s chances of becoming infected with drug-resistant bacterial strains of vancomycin-resistant enterococci (VRE), methicillin-resistant Staphylococcus aureus (MRSA) and C. difficile by 80 per cent.

Lastly there’s what we call the “all-hands-on-deck” approach, combining the latest technological solutions with standard cleaning.

Dr. Mike’s Cleveland Clinic has been a leader in achieving hand hygiene-- the single most effective front-line defence against infection in hospitals. The national average for hand-hygiene compliance in hospitals is less than 50 per cent. An extensive education campaign and the addition of hand-hygiene monitors improved the compliance rate at the Cleveland Clinic to greater than 98 per cent.

Can you imagine yourself insisting that the doctor-- and the nurses-- wash their hands before touching you?