Thousands of Californians die from hospital-acquired infections every year, but the state doesn’t track those deaths, nor does it require hospitals to report when patients are sickened by lethal “superbugs,” according to a report in the Los Angeles Times. An epidemic of hospital-acquired infections is going unreported, the article contends.
In a 2014 study, University of Michigan researchers reported that infections––those acquired both inside and outside hospitals––would replace heart disease and cancer as the leading causes of death in hospitals if the count was performed by looking at patients’ medical billing records, which show what they were being treated for, rather than death certificates.
Experts say hospitals can prevent superbug-related deaths through better infection-control procedures, including some as simple as making sure staff wash their hands, but have little incentive to do so if the deaths are not reported.
“We, the community of physicians, had been watching these patients die and trundling them off to the morgue for years,” said Dr. Barry Farr, former president of the Society for Healthcare Epidemiology of America. “Now we’re in the eighth verse of the same song.”
Federal health officials call pathogens in the carbapenem-resistant Enterobacteriaceae (CRE) family one of the nation’s most urgent health threats. Because of the danger, the Centers for Disease Control and Prevention (CDC) recommends that local health officials require hospitals to report CRE cases. If that isn’t possible, according to agency guidelines, health departments should still survey hospitals and nursing homes for the presence of the superbugs to make sure facilities are trying to halt their transmission.
The CDC advises hospitals that have a patient with CRE to test other patients nearby and those who have shared the same medical equipment to ensure that others are not infected.
Los Angeles County health officials explained to a Times reporter that they had stopped requiring health facilities to report CRE infections in 2012 “due to resource limitations,” although some hospitals voluntarily submit bacterial samples from patients diagnosed with the superbug.
The CDC estimates that 75,000 Americans with hospital-acquired infections die during their hospitalizations each year. Since California provides between 10% and 12% of the nation’s hospital care, state officials used the agency’s analysis to estimate that 7,500 to 9,000 Californians die each year from infections from hospital-acquired germs. But those numbers may be underestimated, perhaps by a great degree, some experts say.
In March, the CDC estimated that the actual number of deaths from sepsis was as much as 140% higher than that recorded on death certificates, or as many as 381,000 deaths each year. According to another study, 37% of hospitalizations for sepsis were caused by infections contracted in hospitals or other health care facilities, such as nursing homes. That suggests that as many as 140,000 Americans are dying each year from health care-acquired sepsis, just one subgroup of the infections.
One reason doctors are reluctant to report in public records that patients have died from hospital-acquired infections, the Times notes, is the possibility of malpractice lawsuits.
CDC officials warned in October that they had discovered that some hospitals had tried to stop their infection-control staff from reporting certain types of hospital-acquired infections to a national database, as required.
In a 2010 survey published in a CDC medical journal, 49% of New York City medical residents said they had knowingly reported an inaccurate cause of death on a death certificate.
Source: Los Angeles Times; October 2, 2016.