Drug-resistant superbugs and other infectious bacteria, including Clostridium difficile, are still very much an issue for one-third of U.S. hospitals — including many flagship teaching hospitals. This data was released in a report by the Centers for Disease Control and Prevention (CDC) earlier this week and comes after several years of warnings, federal fines and embarrassing statistics made public.
The CDC laid the responsibility squarely on doctors, nurses and hospital administrators.
“Doctors are the key to stamping out superbugs. Antibiotic resistance threatens to return us to a time when a simple infection could kill,” CDC Director Dr. Tom Frieden said in the article. “On any given day, about one in 25 hospitalized patients has at least one healthcare-associated infection that they didn’t come in with.
“These infections are not mysterious, he continued. “They’re caused by unwashed hands, rooms that are not cleaned thoroughly, overuse and misuse of antibiotics, a lack of careful hygiene in inserting catheters and other tubes, and slow detection of outbreaks.”
Frieden also mentioned that there are clear and simple steps to avoid this kind of contamination. However, the difficult part is to do them each and every time.
The article explains that the lower-rated hospitals included 24 large, reputable teaching hospitals.
“It’s worrisome that so many hospitals, including academic centers, are exposing their patients to these deadly infections,” Doris Peter, director of the Consumer Reports Health Ratings Center, said in the article. “Teaching hospitals that are training our next generation of doctors should be models for patient safety and best practices; however, far too many of these hospitals fare poorly when it comes to preventing C. difficile, which we see as a red flag for poor patient safety.”
Dr. Peter Pronovost, director of the Armstrong Institute for Patient Safety and Quality at Johns Hopkins, said his hospital was working on the problems. “No hospital is immune from this problem and we all have work to do,” he said.
The Institute of Medicine sounded the loudest alarm in 1999, with a report that estimated anywhere between 44,000 and 98,000 people a year die from medical errors, many of them from hospital-acquired infections.
Since then, the Health and Human Services Department, working through CDC and the Centers for Medicare and Medicaid Services, has worked to try to get on top of the numbers and then get them down, using decreased payments to punish hospitals that don’t hit specific targets.
However, it’s been a tough battle. The article explains that the latest statistics don’t show much progress. The CDC found a 9% decrease in infections called central line associated bloodstream infections from 2008 to 2013. These are infections caused when medical staff insert a narrow tube for long-term infusions of painkillers or other medications, often to the area around the heart.
The report also found an 11% drop in catheter-associated urinary tract infections from 2009 to 2013, and an 8% drop of C. difficile infections between 2011 and 2014. Still, more than 400,000 people get C. difficile every year, which causes severe diarrhea and hits the sickest patients who take antibiotics for weeks or months on end.
“In the U.S., approximately two million people become ill every year with antibiotic-resistant infections, and approximately 23,000 die,” Dr. Clifford McDonald, said.
To curb this, Frieden added that hospital administrators must commit to tracking infection rates openly and then tackling them. “I think there are some low-tech and high-tech solutions here. Some are as simple as handwashing and improved environmental cleaning in hospitals, but some will require new tools.”
These new tools include diagnostic tests that tell doctors quickly if someone has an antibiotic-resistant infection so that they can get appropriate care right away, and be isolated so the infection does not spread.
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