Federal officials are predicting doom because a Pennsylvania woman became infected with a germ that can’t be controlled by most antibiotics. “The medicine cabinet is empty for some patients,” warned the director of the Centers for Disease Control and Prevention, Thomas Frieden.
One would think the CDC was finally ready to get serious about drug-resistant infections. Think again. The CDC watched “super-bugs” spread across the nation, and dawdled. Centers for Denial and Confusion is more like it.
The Pennsylvania woman’s infection is resistant to a last resort antibiotic called colistin. This is the first case, as far as we know, of an infection resistant to colistin in America, but thousands of patients die every year from infections resistant to more commonly used antibiotics.
As antibiotics lose their punch, medical care becomes riskier, especially in hospitals. Patients who need chemotherapy or surgery rely on antibiotics. Without them, even a routine procedure – bypass surgery, or C-section – could turn deadly.
The medical community has struggled with drug-resistance for half a century. There’s no avoiding it. Bacteria naturally evolve to resist weapons we use to fight them. CRE – carbapenem-resistant infections – have plagued New York area hospitals for fifteen years.
CRE bloodstream infections have a 50% death rate. In 2011, a New York patient transferred to the National Institutes of Health in Bethesda, Maryland, carried the germ with her, starting an outbreak that killed several patients, including a 16 year old boy. Now the germ is in more than 40 states. Yet the CDC waited until 2013 to sound the alarm about this “nightmare bacteria.” And has done little since.
Three aggressive steps are needed to protect patients, but the CDC has gotten serious about only one: curbing over-use of antibiotics. The agency is MIA on the need for rigorous cleaning and screening incoming patients for superbugs.
Reducing antibiotic use can only do so much, because the problem is global. In countries like India, antibiotics are as easy to buy as candy. No prescription needed. Patients then come to American hospitals bringing the drug resistant bacteria with them.
Plus, simply curbing antibiotic use doesn’t stop patients from getting most infections in the first place and has barely made a dent in death rates in hospitals. Nearly 75,000 patients die from infections in U.S. hospitals each year. To stop this carnage, hospitals need to clean up.
Shockingly, one’s risk of getting an infection often depends on your hospital room number. If a previous patient in that room had a superbug, you’re in danger. The previous patient's germs are still lurking on the bedrail and privacy curtain.
Half the surfaces in a hospital room are overlooked by cleaning staff. There are technologies to overcome this human error –robotic hydrogen peroxide misters, UV light machines and newer devices that operate 24/7 to disinfect a room with no risk to patients. But the CDC drags its feet about recommending them.
So, if you’re visiting someone in the hospital, skip the flowers. Instead bring bleach wipes and clean surfaces around their bed. You could save a life.
The CDC’s failure to call for screening incoming patients defies reason. During the AIDS crisis, the CDC recommended testing all patients for AIDS. Why not superbugs? Hospital infections kill four times as many people. And contracting AIDS is difficult, but picking up a hospital germ is as easy as touching the call button.
New screening tools can detect superbugs in minutes, instead of old-fashioned cultures that take three days. As a result, patients who test positive for a superbug can be whisked into a single room to stop their germs from spreading.
Using a new rapid test, hospitals in the Washington D.C. area screened patients and found more than 5% unknowingly carry deadly CRE germs. That shows the urgent need to make screening routine.
The intractable infection in Pennsylvania is a wake-up call. Patients and advocates need to demand aggressive infection-prevention in hospitals. We have the tools to eradicate these infections. What is lacking is the will.