A harsh reminder of hospital infection risks: outbreaks in areas treating kids

childrensseattle-300x156Parents and the public received grim reminders of the risks of medical care as prominent institutions on opposite coasts battled hospital-related infections among some of the most vulnerable patients around: babies and children.

In the Pacific Northwest, a mold outbreak has taken a terrible toll — with one patient dead, five others infected, 1,000 surgeries postponed and 3,000 people told to watch for infection symptoms — at Seattle Children’s Hospital, which the Washington Post reported, “consistently ranks as one of the best children’s hospitals in the country and this year [was] rated top [for such facilities] in the Northwest.”

In the Northeast, the University of Pittsburgh Medical Center Children’s Hospital has confirmed 12 cases of a drug-resistant staph infection in its neonatal intensive care unit (NICU), CNN reported, adding that, the six babies, including one who is potentially symptomatic, and six symptomatic employees who have tested positive for Methicillin-resistant Staphylococcus aureus (MRSA) are receiving treatment.

Mold infects a kids’ hospital

The mold infections, according to news reports, likely involve the fungus Aspergillus. The federal Centers for Disease Control and Prevention describes this bug as a “common mold (a type of fungus) that lives indoors and outdoors. Most people breathe in Aspergillus spores every day without getting sick. However, people with weakened immune systems or lung diseases are at a higher risk of developing health problems due to Aspergillus. The types of health problems caused by Aspergillus include allergic reactions, lung infections, and infections in other organs.”

Hospitals take pains to reduce Aspergillus outbreaks, employing extensive air filtration systems to keep spores from spreading and taking other measures, including barring certain patients from receiving gifts of plants or flowers or being in wings where windows or doors may be open and near gardens or lawns that are being replanted or covered with mulch or compost. Seattle Children’s said it conducted a vigorous investigation of its systems, finding issues in the hospitals air handling and filtration. It has fixed those, cleaned extensively, and shut down facilities and activities in an abundance of caution.

Because the hospital serves a big chunk of the country, including with facilities in four states, area hospitals have cooperated and taken up some of the specialized patient care.

MRSA woes in NICU

In Pittsburgh, the MRSA outbreak in the neonatal intensive care unit has been blamed on a visitor, though hospital officials have not provided details of their investigation that led them to this conclusion.

Doctors say the staff and babies with the staph infection are doing well and responding to treatment, which has improved, due to the frequency now of MRSA outbreaks. As CNN reported of these infections:

“An estimated 119,247 staph bloodstream infections were seen in 2017, which resulted in 19,832 deaths, according to a recent CDC report. From 2005 to 2013, the rates of MRSA bloodstream infections diagnosed in hospitals declined on average 17.1% every year, however no significant change in infection rates has been observed since, the CDC says. In health care settings, MRSA is usually spread by contact with an infected wound, by someone who is infected or someone with contaminated hands, according to the CDC. Patients can also become infected with MRSA when they touch contaminated bed linens, bed rails, medical equipment or other contaminated surfaces. Unlike healthy people, hospital patients are more susceptible to MRSA due to their existing illness, having unhealed wounds or invasive medical devices (such as catheters). Certain procedures like surgery or dialysis can also increase a person’s risk of developing a MRSA infection. That said, healthy people who have not visited a hospital or a nursing home can also become infected with MRSA, the CDC says.”

In my practice, I see not only the harms that patients suffer while seeking medical services, but also the significant risks they may be exposed to when treated at hospitals, even the best, most caring, and careful institutions with major reputations.

Although the fatalities have declined, preventable hospital deaths kill more than 160,000 Americans annually — four times as many lives as were lost to vehicle wrecks in 2017, more than twice the deaths attributable to opioids and drug overdoses that year, and more than the toll of stroke or Alzheimer’s disease. That disturbing information comes from Johns Hopkins Medicine’s Armstrong Institute for Patient Safety and Quality and the Leapfrog Group, a national nonprofit founded by large employers and others concerned and focused on safety and quality in health care.

Hospital deaths, by the way, are a slice of the 250,000 lives lost each year due to medical error. Medical errors claim the lives of roughly 685 Americans per day─ more people than die of respiratory disease, accidents, stroke and Alzheimer’s. That estimate comes from a team of researchers led by a professor of surgery at Johns Hopkins. It means medical errors rank as the third leading cause of death in the U.S., behind only heart disease and cancer.

Hospitals keep insisting they’re doing all they can to attack infections their already ill or injured patients acquire while in their care. But more needs to be done, as the Leapfrog Group has reported:

“Healthcare-associated infections (HAIs) are a common and complicating — yet largely preventable — factor for hospitalized patients. Each day, around one out of 25 patients in U.S. hospitals contracts an HAI. These infections can significantly delay recovery, increase the expense of a hospital stay, and even result in death. Of the approximately two million American patients who acquire an HAI annually, an estimated 90,000 will die. Yet studies have shown that selected HAIs can be reduced by as much as 70% with the help of the proper patient safety interventions. The cost of a single case can range from just under $1,000 to nearly $50,0004, depending upon the type of infection — with the direct cost of HAIs to hospitals estimated at between $28 billion and $45 billion. These costs are passed along to insurers and employers, as well as to patients themselves in the form of higher out-of-pocket costs.”

There’s clearly a lot of work that needs to be done — and let’s hope that doctors and hospitals can better keep in check HAIs so they don’t afflict and sicken or kill any more kids.

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