Patient with MRSA wound following abdominal surgery.
They can spread by touch, electronic thermometers, endoscopes, laboratory coats, soiled gowns, blood, touching, coughing, sneezing, talking, air, water, intravenous fluids, food, rats and flies. It only takes three things for a hospital superbug (strain of bacteria resistant to powerful antibiotics) to infect a patient: the existence of the bacteria in the hospital, a susceptible patient, and a mode of transmission such as a touch by doctors and nurses. Should you be concerned?
Last month major news outlets, medical conferences and Twitter were buzzing about NDM-1, (New Delhi Matallo-beta-lactamase) a newly discovered gene that makes bacteria resistant to last-resort antibiotics called beta-lactams or carbapenems. The Associated Press reported that, so far, the gene has mostly been found in bacteria that cause gut or urinary infections. The CDC discovered NDM-1 in the U.S. this year, with cases occurring in people from California, Massachusetts and Illinois. But the CDC says the NDM-1 bacteria are rare in the U.S. and have been found mainly in people who obtain medical treatment in India, reported USA Today.
Even scarier are gram-negative superbugs called carbapenem-resistant Enterobacteriaceae (CRE), diagnosed mostly in hospital patients and are far more common than bacteria carrying NDM-1, which is actually just one type of CRE. CRE bugs produce an enzyme (called Klebsiella pneumoniae carbapenamase, or KPC) that is resistant to carbapenem antibiotics, known as “antibiotics of last resort.” Drug-resistant KPC cases have been reported to the CDC by hospitals in about 35 states and are fatal in 30% to 60% of cases. Gram-negative bacteria can cause severe pneumonia and infections of the urinary tract, bloodstream and other parts of the body. While US health officials don’t know the exact numbers of gram negative infections and related deaths, the CDC estimates that 1.7 million hospital-associated infections, from all types of bacteria combined, cause or contribute to 99,000 deaths each year. That puts hospital-acquired infections in the top-ten category of leading causes of death in the US.
Superbugs like these point to a growing problem of antibiotic resistance in the U.S. which is further complicated by the lack of available treatments for patients who’ve been infected. The real alarm is that hospitals have known about other deadly superbugs for years, and they’re still not doing enough to protect patients from serious harm.
Overall, hospitals have been dragging their feet when it comes to protecting patients from deadly superbugs, and these bugs are getting smarter and more deadly. Hospitals still haven’t managed to control the spread of superbugs lurking in their buildings such as MRSA (methicillin-resistant Staphylococcus aureus), the single most common source of hospital infections harming about 94,360 people yearly and 18,650 of them dying; and C.diff (clostridium difficile) which is responsible for between 165 and 438 patients dying every day according to one study. With slim to limited treatment options, the focus should be on preventing and eliminating hospital infections. As experts have known for decades, consistent hand hygiene by healthcare professionals is the first line of defense. Yet clinicians do it only 30% of the time, says Peter Pronovost, PhD, MD. Another problem in healthcare delivery is improper antibiotic use and repeated use, which creates more opportunity for antibiotic-resistant bacteria to grow.
According to Brandi Limbago at CDC: “The challenge now is motivating the healthcare community to take action, including using antibiotics wisely, following transmission prevention guidelines, and implementing overall infection prevention recommendations.” When information about where these superbugs are creeping up and how frequent they are is made public, hospitals are more likely to step up their infection control efforts.
Now, the public is being made aware of hospital superbugs through news stories, or worse, they or their loved ones are getting infected. Information guides about protecting yourself from infections is made available through resources like Consumer Reports’ hospital survival guide. But we need hospitals to think about the countless patients being harmed and those of us who simply expect better protection from hospitals.
Antibiotic resistance is not a new problem but it’s a growing one that needs to be addressed quickly. At this point, the superbugs are moving faster than our health care system’s ability to tackle the problem, putting patients at risk.