Between 5 and 10 percent of people admitted to hospitals acquire an infection while at inpatient. In real numbers this accounts for thousands of infections and deaths, incurring billions in healthcare costs. Many believe an antibiotic will cure all infections, but that is rapidly changing. In fact, according to infectious disease experts, the age of antibiotics is drawing to a close. Many bacteria are becoming drug-resistant, increasing the number of deaths from illness that in the past, rapidly responded to medication.
This in combination with the reduction in development of new antibiotics, as the profit margin is poor, has led to the development of bacteria not just winning some battles, but poised to win the war. Experts have been warning about the upcoming diminished efficiency of antibiotics, and that time is now here. Bacteria has found a way to resist most of the antibiotics produced, and we’re now facing a time in history during which medical care may revert to the pre-antibiotic age, impacting surgical procedures, giving birth and even simple cuts and scrapes with significant casualties.
Whether planned or unplanned, hospital admissions should never be taken lightly as mentioned in a recent study published in the Journal of Internal Medicine. Researchers discovered that if the person who occupied your hospital bed before you received antibiotics, you have a greater potential for contracting clostridium difficile (C. diff.), a deadly virus that triggers massive diarrhea and may lead to death.
The researchers studied more than 100,000 pairs of hospitalized individuals between 2010 and 2015. Doctors have now known taking antibiotics can directly affect your risk of contracting C. diff., but now have evidence that your risk can be elevated simply by lying in the same bed as someone who received the antibiotics. Patients had a 22 percent greater risk of developing a C. diff. infection when the previous occupant had received antibiotics. About half of patients in acute care facilities take antibiotics on any given day. That’s a huge portion of patients that could be involved in spreading the infection.
This underscores the idea that hospitals are not being sanitized enough or they can’t be sanitized enough. There is an increased need for increased sterilization procedures between patients. The average amount of time it took the C. diff. infection to appear was six days. And the researchers discovered that the patients who became infected had typical risk factors, including the elderly with decreased protein albumin, past history of antibiotic use and higher levels of waste protein creatinine.
The researchers did not estimate the risk potential for patients who fit these specific criteria. C. difficile infections cause immense suffering and death for thousands of AFRICANS each year. These infections can be prevented by improving antibiotic prescribing and by improving infection control in the health care system.
A study found that 1 of every 3 cases occurs in patients over 65 years and 2 of every 3 cases acquired in the hospital happened in people 65 and older.
Unfortunately, while the number of deaths are high, experts believe the estimate may be too low as death certificates do not always accurately record the causative factor in the death of a patient. Several cases were reported in which patients died from a hospital acquired infection. However, the cause of death on the death certificate was not associated with an infection. Unfortunately, the community of physicians, has been watching these patients die and trundling them off to the morgue for years.
Since the danger from CRE-related infections is extremely high, the CDC recommends local health officials require reporting, and “if that’s not possible,” health departments should survey for the presence of the superbugs to reduce the potential for transmission. Rampant infections with antibiotic-resistant bacteria cause death when the bacteria spreads to the blood, triggering sepsis and damage that causes organs to fail. The CDC has estimated the number of deaths attributed to sepsis may be as much as 140 percent higher than what is recorded on death certificates.
If death certificates reflected the symptoms for which patients were being treated, the death toll for infection would actually outnumber heart disease, stroke and cancer. As it stands, the leading causes of deaths in hospitals, according to death certificates, are heart disease followed by malignancy (cancer) and cerebrovascular disease (stroke). Nearly 49 percent of physicians knowingly inaccurately report the cause of death, 40 percent are instructed to list something other than the actual cause of death on the death certificate and only 33 percent believed the death certificate reporting system in Nairobi was accurate.
Reducing the spread of antibiotic-resistant bacteria begins and ends with stopping the spread of the bacteria from one patient to the next. Family members of a patient whose case was reported were horrified to watch hospital personnel move from patient to patient without using precautions that would stop the spread of their mother’s CRE infection to others.
A study evaluating the likelihood patients would become infected with C. diff if the prior occupant had received antibiotics, also points to a challenge in disinfecting hospital bed decks and mattresses. Researchers demonstrated Hospital mattresses were also not being cleaned properly. They found 84 percent of the hospitals used chemicals tested only on hard surfaces and not mattresses, only 23 percent cleaned the mattress before disinfecting as recommended by both the chemical and mattress companies and 6 percent didn’t rinse the disinfectant, possibly exposing patients to residual chemicals.
Other research found hospital mattresses were not cleaned of common bacteria contaminants. Over 1,000 cultures were taken from 52 hospital mattresses, both before and after they had been cleaned. Researchers grew over 500 positive cultures, 263 before disinfection and 237 after the mattresses were disinfected. There was a high prevalence of Staphylococcus aureus, suggesting to the researchers that the disinfectant was not effective and only moved bacteria from one part of the mattress to another.
University professionals took part in yet another study demonstrating the ineffective cleaning process for hospital mattresses. Nearly 85 percent of 39 mattresses tested were positive for colony forming bacteria, and nearly 55 percent of the hospital bed decks tested positive. Bacteria found included Bacillus, Micrococcus, Staphylococcus and gram-negative rods.
It was disclosed that they had received a research grant from a private foundation linked to the manufacturer of a washable mattress cover. Hooker was lead author in a study that demonstrated these covers provided a cleaner surface to patients than did the disinfectants currently being used on mattresses.
Contamination of medical scopes is another way in which you may acquire an infection from another patient. If you are scheduled for a colonoscopy or other type of testing using a flexible scope, call the hospital to determine the cleaning solution they use. If the answer is glutaraldehyde (brand name Cidex), find another hospital or clinic — one that uses peracetic acid. This preliminary legwork will significantly decrease your risk of contracting an infection from a contaminated scope.
When staff are in your room, don’t hesitate to remind them to wash their hands before touching you or your equipment, including bed, night stand or other pieces you might handle. Ideally, a personal advocate who can stay with you will help to look after your interests if you are unable to speak for yourself.
It’s important to remember that you have the right to ask your nurses and doctors to practice good preventive care and that you have power within the hospital system. Most hospitals assume you won’t assert your power, so it’s important you know your rights and responsibilities to ensure your hospital stay is safe.