Nasty bug surges in hospitals, especially notable teaching centers

cdiff-e1457129921513Although hospitals across the country have campaigned to reduce infections that their patients acquire while under their care, a particularly nasty bug surged in their most recent reporting year. Hospital acquired infections (HAIs) involving C diff  (Clostridium difficile) bumped up by 4 percent, the federal Centers for Disease Control and Prevention reported.

Consumer Reports says the increase shows the struggles to reduce HAIs, including in some of the biggest name health care institutions like Johns Hopkins. The consumer magazine also calls out other teaching hospitals, including the University of Maryland Medical Center, Cleveland Clinic, Massachusetts General, Cedars-Sinai Medical Center,  Yale-New Haven, Mount Sinai in New York, and Brigham and Women’s Hospital in Boston.

“New data show that far too many patients are getting infected with dangerous, drug-resistant bacteria in healthcare settings,” said CDC Director Tom Frieden. “Doctors and healthcare facilities have the power to protect patients–no one should get sick while trying to get well.”

The CDC said hospitals have achieved between 2008 and 2014: a 50 percent decrease in central line-associated bloodstream infections;  a 17 percent decrease in infections involving 10 different kinds of surgical sites; and no change in the overall catheter-associated urinary tract infections.

As for C diff, it is the most common type of bacteria responsible for HAIs, the agency said. It caused almost half a million infections in the United States in 2011 alone. Infections with this bug had decreased by 8 percent between 2011 and 2013, before they jumped in 2014.

Consumer Reports says C diff infections go down when hospital staff practice rigorous hand and procedure hygiene and scour rooms, implements, and any sources that patients can come into contact with C diff. The germ hangs on, on door knobs, bed rails, and other surfaces for weeks. Antibiotic over- and mis-use worsens efforts to curb C diff; researchers are focusing more on how common heartburn medications may upset favorable gut bacteria and activity, increasing C diff infections.

C diff sickened 101,074 hospital patients in 2014, the CDC said, and other research shows that overall about 450,000 people a year, in and out of hospitals, fall ill from it; it contributes to the death of about 29,000 people annually.

Johns Hopkins has said it aggressively seeks to rein in HAIs. The hospital, like many others, says its C diff infections may appear bad because teaching and academic medical centers treat the sickest patients; many already have infections, including with C diff, on admission. Teaching hospitals also may diagnose and detect HAIs more robustly than other institutions.

Under the Affordable Care Act, hospitals are under increasing regulatory and financial pressure to cut HAIs. The government, in a step that Consumer Reports says needs even more attention, also forces heightened monitoring and reporting of data on care.

A health care data decision decried

Separately, health care watchdogs expressed regret over a new U.S. Supreme Court ruling that curtailed budding efforts to increase the reporting and transparency of data on patient care quality, cost, and access.  The high court, the investigative news site Pro Publica reports, ruled that a 1974 law precludes states from requiring that every health care claim involving their residents be submitted to a massive database. As the site reported:

The arguments were arcane, but the effect is clear: We’re a long way off from having a true picture of the country’s health care spending, especially differences in the way hospitals treat patients and doctors practice medicine. It also means that, for the time being at least, we’ll remain heavily reliant on data being released by Medicare, the federal health insurance program for the elderly and disabled, to study variations in health care.

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