The killers that even top hospitals just wink at
Worried about breast cancer? Or AIDS? Bad as these dreaded diseases are, hospital infections kill more people yearly than both of them combined. Amazing — something caused by the hospital is so deadly.
New research in the latest issue of Critical Care Medicine shows doctors and other hospital staff routinely ignore steps known to protect patients from infections, such as putting on a mask and gown before doing certain procedures. They have the knowledge to prevent infections. What they’re lacking is the will.
Hospital infections are a problem everywhere, but especially in New York City. Hospitals here are plagued by the deadliest hospital infection, CRE, which is highly resistant to antibiotics.
The Centers for Disease Control and Prevention call this superbug “nightmare bacteria,” because it kills up to 50 percent of infected patients. When a handful of patients contracted CRE in Los Angeles because of contaminated endoscopes, it made front-page news.
But in New York, where each year more than 1,600 patients contract CRE (carbapenem-resistant Enterobacteriaceae), there’s silence. Hospitals keep it hushed.
This summer Consumer Reports started rating hospitals for infection risk, and found that even New York City’s most respected hospitals — New York-Presbyterian and NYU Langone — earn only average grades. This despite being named by US News & World Report as the best places to go if you’re seriously ill.
Overall, hospitals in New York state perform below the national average on infection prevention, according to the state Health Department.
At least 80,000 patients a year get infected in hospitals here. Even Gov. Cuomo’s household has felt the pain. His girlfriend Sandra Lee endured two hours of surgery this month to treat a “monster infection” from a breast-cancer operation. Being a celebrity is no protection against bugs with names like MRSA, CRE and C. diff.
C. diff sickens the largest number of patients. It causes severe diarrhea, sometimes permanent damage to the colon and other complications.
How do you get it? Oral-fecal contamination, meaning invisibly small particles of someone else’s waste get into your mouth. Thanks to inadequate hospital cleaning, the germ lurks on bed rails, faucet handles and table tops — even for weeks.
Patients touch these surfaces, then touch their mouth or food and swallow the germ. Just being assigned to a hospital room where a C. diff patient was treated can be a death sentence.
Too often hospital staff ignore the risk. This weekend I watched a technician go from room to room giving frail patients a swallowing test to make sure they could eat.
At each bedside, the technician set a spoon on the patient’s table — a surface commonly contaminated with C. diff — then used the spoon to feed the patient. This tech was potentially a walking vector of death.
Rigorous cleaning is the answer to C. diff. The Mayo Clinic reduced it by 85 percent simply by cleaning surfaces around patients’ beds once a day with a bleach wipe.
Why isn’t every hospital doing this? Pay attention, Memorial-Sloan Kettering, Long Island Jewish, St. Barnabas and Buffalo General. These hospitals have among the worst C. diff problems, according to state data.
The good news is that New York area hospitals have made substantial progress against one killer — “central line” infections, caused when bacteria invade the bloodstream.
Hospitals here have cut this type of infection by half since 2007, with New York-Presbyterian and NYU Langone performing among the best.
The terrifying news is that virtually all hospitals in New York City are struggling with CRE and are making little progress.
Last weekend, I heard from a CRE victim’s widow. She told me her husband, a highly decorated former Marine sergeant who made it through two tours in Vietnam and three heart operations, died in one of the city’s award-winning hospitals.
“He survived Nam, he survived many operations, but because the hospital or their staff or their equipment wasn’t clean enough, he died from a hospital acquired infection . . . He was stolen from us.”
Betsy McCaughey is chairman of the Committee to Reduce Infection Deaths and a former lieutenant governor of New York.