Superbugs and Hospital-Acquired Infections (HAIs)

No discussion of patient safety would be complete without covering the growth of superbugs, infectious organisms that make patients sick and may even cause death. They are called superbugs because it's very difficult to kill them with existing drugs, which limits treatment options.

Superbugs are known by names such as:

• Methicillin-resistant Staphylococcus aureus (MRSA)
• Clostridium difficile (C.Diff)
• Vancomycin-resistant enterococci (VRE)
• Carbapenem-resistant Enterobacteriaceae (CRE) and Carbapenem-resistant Klebsiella pneumoniae (CRKP)
• Necrotizing fasciitis, the flesh-eating bacterial disease

Perhaps surprisingly, some of these organisms are present naturally in our environment and they do not make healthy people sick. For example, about one-third of people are "colonized" with the bacteria ​Staph aureus, meaning it lives on the skin in the noses of people without causing disease. Approximately one percent of people are colonized with the antibiotic-resistant form of staph aureus (known as MRSA). The percentage is higher for people who have been recently hospitalized.

C. Diff lives all around us, too, including in human digestive systems. The problem with this superbug is that it won't cause problems until the person begins to take antibiotics for another illness. At that point, the C. Diff can colonize out of control making the infected person much sicker.

Superbugs are invisible and can survive on surfaces for up to three days. That means that they can be transferred when one infected person simply touches another person. They can also be transmitted when the patient touches something on which the pathogen resides, such as a stethoscope, a TV remote, a computer mouse, or shared athletic equipment.

According to the Centers for Disease Control and Prevention (CDC), an estimated one in 25 Americans contracts a hospital-acquired nosocomial infection (HAI) each day. They are admitted to the hospital injured, debilitated, or sick and are easily susceptible to a colonized infection. Others in the hospital—some sick and others healthy—can introduce the pathogen and the superbug can then take hold and begin growing out of control.

Infectious pathogens find easy access to the bloodstream of a patient with an open wound from an injury or surgery. Once the germs enter the bloodstream, the patient is said to have sepsis or septicemia. Patients who are sick with another disease or condition may have a compromised immune system, making them too weak to fight off a superbug. The elderly are especially susceptible because their systems may already be fragile due to their age.

Once the patient is infected, the hospital stay is extended, sometimes for months. In some cases, the infection can be controlled enough so the patient can eventually leave the hospital. But many patients aren't so lucky. Of the 1.7 million Americans who are infected in hospitals each year, at least 99,000 of them die from those infections.

Due to the prevalence of HAIs and the fact that many are preventable, the Medicare system penalizes hospitals with high rates of HAIs. In these instances, Medicare reimbursements are reduced and the penalties are seen as a way to forcefully encourage hospitals to step up prevention efforts. 

There are a number of additional steps that patients can take when they are serious about preventing hospital-acquired infections. For instance, you can look into the infection rate of a hospital or doctor and be aware of how infections are most often spread in hospitals. Basic sanitary practices can help tremendously in reducing infections as well.

Superbugs and hospital-acquired infections can be a scary topic that you might not want to think about. However, it's important to remain aware of the potential risks so a seemingly minor hospital stay doesn't turn into a larger problem. A little diligence and knowledge before your hospital admission can make a difference.