Archive for Monday, March 19, 2007

Deadly germs take grim toll in hospitals

March 19, 2007


— The week before Christmas was filled with excitement for 6-year-old Macenzie and her mother, Lacie Simmons.

They decorated the tree, shopped and put an inflatable snow globe in the yard.

The festive mood ended abruptly Dec. 20 when Simmons collapsed in the hallway of her parents' Grand Prairie, Texas, home. When the EMTs arrived, Macenzie clung to her mother.

"I just need to take care of my mom," she repeated as she patted her mother's arm. It was the last time she saw her mother alive.

"Her blood pressure bottomed out, her heart failed and that was it," said Lacie's mother, Renee Simmons.

Within 26 hours, Lacie Simmons was dead. A preliminary autopsy showed that an infection killed her. Back surgery three weeks earlier had hardly slowed the single mother.

But her parents believe she picked up the infection after surgery to fuse two discs in her spine.

Reduce your infection risk

¢ Ask hospital staff to clean their hands before treating you.¢ Ask that the diaphragm of the stethoscope be wiped with alcohol before use.¢ If you need a central line catheter, ask your doctor about one that is antibiotic-impregnated or silver-chlorhexidine coated to reduce infections.¢ If you need surgery, choose a surgeon with a low infection rate. Surgeons know their rate of infection for various procedures. If a surgeon refuses to tell you, consider choosing someone else.¢ Three to five days before surgery, shower daily with 4 percent chlorhexidine soap, available through pharmacies.¢ Stop smoking well in advance of your surgery. Patients who smoke are three times as likely to develop a surgical site infection as nonsmokers.¢ Do not shave the surgical site. If hair must be removed, ask that clippers be used.¢ Ask that your surgeon limit the number of people in the operating room.¢ If you must have an IV, make sure that it is inserted and removed under clean conditions and changed every three to four days. Alert hospital staff if any redness appears.¢ If you are planning to have a cesarean section take the same precautions as you would for any surgery. Women who have cesarean sections are 10 times more at risk for infection that those who give birth vaginally.Source: Committee to Reduce Infection Deaths

Anyone who goes into the hospital could end up the same way as Lacie, who was just 28 and healthy, Simmons said.

"It's a crapshoot," she said.

Each year, an estimated 2 million patients - 1 in 20 people - get a serious infection while hospitalized on an outpatient or inpatient basis, according to the Centers for Disease Control and Prevention.

More than 90,000 of these patients die, most often from infections acquired through intravenous tubes, catheters and ventilators.

Treating them costs the country more than $4.5 billion a year.

Infections lurking in the nation's hospitals have been a well-kept secret for years because information is not publicly reported, said Lisa McGiffert, director of Consumers Union's Stop Hospital Infection Campaign in Austin, Texas.

"People need to understand that hospitals are full of bacteria," she said. "It lives in the environment, and nurses and doctors carry that bacteria from patient to patient."

Many hospitals already collect data and are trying to address infection rates with prevention programs.

At least 39 states have introduced legislation pushing hospitals to publicly disclose how many patients get serious infections, McGiffert said.

Four years after drug companies starting mass-producing penicillin in 1943, microbes that could resist it started cropping up, according to the Food and Drug Administration.

In the 1970s, the problem worsened as soldiers returning from Vietnam brought home penicillin-resistant gonorrhea. Since then, overuse of antibiotics led to a growing list of drug-resistant organisms. The Centers for Disease Control and Prevention estimates that, today, 70 percent of the bacteria that cause hospital infections are resistant to at least one antibiotic.

One of the biggest threats is the staph infection MRSA. Nearly three-fourths of patients' rooms are contaminated with the bacteria that cause it, according to the Committee to Reduce Infection Deaths, or RID, an advocacy group.

A health care worker need only touch a contaminated cabinet or bedrail to spread the infection to the next person. White coats, stethoscopes and blood pressure cuffs can also carry bacteria.

Myron Skinner, a retired Texas pathologist, got a staph infection after heart surgery in 2006.

Skinner was a robust 81-year-old who had spent a month traveling through Europe before coming home to have surgery. Skinner and his wife, Jane, expected him to recover without complications.

"When he went through the doors to surgery, I never thought I would not have another trip to Europe - and neither did he," Jane Skinner said. "He was as chipper as he could be."

A week after surgery, his lungs filled with fluid and staph pneumonia set in, Skinner said. Doctors tried at least seven antibiotics before he died six weeks later.

Watchdog groups have taken a close look at how the nation's hospitals got so sick. The biggest culprit: lack of hygiene.

While CDC guidelines call for health professionals to clean their hands between patients and wear a mask, sterile gown and gloves while inserting an IV, in reality, it happens less than 50 percent of the time, according to the National Quality Forum.

"It's something our mothers taught us, but people get busy and don't realize they haven't washed their hands," said Dr. William Sutker, director of medical education for Baylor University Medical Center in Dallas.

Hand-washing could prevent 20,000 patient deaths each year, according to the CDC.

"We can't get rid of all infections just by washing our hands every time, but that will help," McGiffert said.

Most hospitals collect infection data, but few report the results to a regulatory agency, accreditation board or the public, according to Consumers Union.


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