What the Centers for Disease Control and Prevention (CDC) is calling a “winnable battle”1 is currently claiming the lives of tens of thousands of Americans every year.
According to the CDC, between 5 and 10 percent of people admitted to the hospital acquire an infection while an inpatient.2 In real numbers this accounts for 1.7 million infections and 99,000 deaths, incurring $20 billion 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.
Last Hospital Bed Occupant May Predict Your Infection Rate
Whether planned or unplanned, hospital admissions should never be taken lightly as mentioned in a recent study published in the Journal of the American Medical Association (JAMA) 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.3
The researchers studied more than 100,000 pairs of hospitalized individuals between 2010 and 2015.4 Doctors have 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. Kevin Brown, Ph.D., an assistant professor and researcher at the University of Toronto School of Public Health, told Reuters:5
“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.”
According to Dr. Marc Siegel, professor of medicine at New York University Langone Medical Center:6
“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.”
Elderly Are at Greatest Risk
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 elderly with decreased protein albumin, past history of antibiotic use and higher levels of waste protein creatinine.7
The researchers did not estimate the risk potential for patients who fit these specific criteria. In the overall population the association was small, and the study was not able to establish a causal relationship.
Siegel warns that this is just another way that the prescription and use of antibiotics should not be viewed as harmless. According to the CDC, nearly 500,000 Americans are infected with C. diff. each year.8 More than 100,000 of these people reside in nursing homes.
Approximately 29,000 of those die within the first 30 days of the infection. If a patient acquired C. diff in the hospital, 1 of every 5 would experience a recurrence of the infection. According to CDC Director Dr. Tom Frieden:
“C. difficile infections cause immense suffering and death for thousands of Americans each year. These infections can be prevented by improving antibiotic prescribing and by improving infection control in the health care system.”
A study by the CDC 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.9
Superbug Reporting May Reveal True Scope of Hospital-Acquired Infections
Senator Jerry Hill of California plans to introduce a bill that will require hospitals in his home state to report lethal superbug infections.10 California state officials estimate that between 7,500 and 9,000 people in their state die each year from these hospital-acquired infections.
As the state doesn’t track the infections or deaths from superbugs, they estimate this number based on the annual deaths across the U.S. 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.
The bill Hill plans to introduce will require hospitals to report up to 22 different types of infections.
Although California now reports a handful of infections, it does not report infections with Carbapenem-resistant Enterobacteriaceae (CRE), a family of bacteria with high levels of resistance to antibiotics. According to the CDC this is an emergency threat to public health.11
In a related article in the Los Angeles Times, several cases were reported in which patients died from a hospital acquired infection in California. However, the cause of death on the death certificate was not associated with an infection.12
As noted by Dr. Barry Farr, retired former president of the Society for Healthcare Epidemiology of America:13
“We, the community of physicians, had been watching these patients die and trundling them off to the morgue for years. Now we’re in the eighth verse of the same song.”
Hospital-Acquired Infections Are Even More Deadly Than Previously Reported
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.14
Curiously, Los Angeles County stopped requiring hospitals to report infections, despite the indication they were a “high-prevalence region” for the superbug.15
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.
In a study at the University of Michigan, researchers discovered similar data. 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.16
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).17 Speaking about CRE infections in 2013 to USA Today, Frieden said:18
“These are nightmare bacteria that present a triple threat. They’re resistant to nearly all antibiotics. They have high mortality rates, killing half of people with serious infections. And they can spread their resistance to other bacteria.”
More evidence from a CDC research report published in 2010 shared frightening survey results from New York City doctors.19
Nearly 49 percent of these physicians had knowingly inaccurately reported the cause of death, 40 percent had been 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 New York City was accurate.20
Many Hospitals Fail to Follow Proper Cleaning Procedures
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 in the Los Angeles Times 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.21
The JAMA 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 at Xavier University in Cincinnati demonstrated hospital mattresses were also not being cleaned properly.22 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.
Hospital Mattresses and Bed Decks Testing Positive for Colony Growing Bacteria
Other research found hospital mattresses were not cleaned of common bacteria contaminants.23 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.
Xavier 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.25 Bacteria found included Bacillus, Micrococcus, Staphylococcus and gram-negative rods.
Dr. Edmond Hooker from Xavier University presented these findings at the annual Association for Professionals in Infection Control and Epidemiology (APIC). During his presentation he said:26
“The current research fits into the growing body of evidence that the hospital environment is dirty; is not being cleaned well enough; and that this failure to clean the environment is leading to hospital-acquired infections and deaths. Hospitals must stop ignoring the hospital environment as the source of hospital acquired infections.”
Xavier University disclosed they had received a research grant from a private foundation linked to the manufacturer of a washable mattress cover.27 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.28
Strategies That May Save Your Life When You’re Hospitalized
In the video above, Andrew Saul, Ph.D., co-author of the book “Hospitals and Health: Your Orthomolecular Guide to a Shorter Hospital Stay,” discusses the dangers of hospital stays, the type of patient that tends die more frequently and how you can protect your health, or the health of a loved one, in the event you have to be hospitalized.
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.
Written by Dr. Mercola
Sources and References
- 1Centers for Disease Control and Prevention, Healthcare – Associated infections
- 2Centers for Disease Control and Prevention, Preventing Healthcare-Associated Infections
- 3Receipt of Antibiotics in Hospitalized Patients and Risk for Clostridium difficile Infection in Subsequent Patients Who Occupy the Same Bed
- 4,5Reuters, October 2016, Antibiotic history of a hospital bed may increase a patient’s risk of infection
- 6,7U.S. News and World Report, October 10, 2016, If Patient in the Hospital Bed Before You Got Antibiotics — Take Heed
- 8,9Centers for Disease Control and Prevention, February 2015, Nearly half a million Americans suffered from Clostridium difficile infections in a single
- 10The Los Angeles Times, October 2016, Hospitals in California would have to report superbug infections under planned legislation
- 11Centers for Disease Control and Prevention, Carbapenem-resistant Enterobacteriaceae (CRE) Infection: Patient FAQs
- 12,13,14,15,21Los Angeles Times, October 2016, No one knows how many patients are dying from superbug infections in California hospitals
- 16PLOS|One, May 2014, Death Certificates Underestimate Infections as Proximal Causes of Death in the U.S
- 17,20MRSA Topic, October 2016, THE LEADING CAUSES OF DEATH ARE HEART DISEASE AND CANCER — RIGHT?
- 18USA Today, March 6, 2013, CDC sounds alarm on deadly, untreatable superbugs
- 19Centers for Disease Control and Prevention, 2013, Survey of New York City Resident Physicians on Cause-of-Death Reporting, 2010
- 22Infection Control Today, June 2012, Researchers Say Hospitals Use Unapproved Chemicals to Clean Hospital Beds
- 23,24Scielo Public Health, March 2000, A bacteriological study of hospital beds before and after disinfection with phenolic disinfectant
- 25,26,27Healio Infectious Disease News, July 2011, Common procedure for cleaning hospital beds failed to eliminate bacteria
- 28Antimicrobial Resistance & Infection Control, July 2012, A randomized trial to evaluate a launderable bed protection system for hospital beds