Personal Health

Infection: How Hospitals Are Breeding Grounds for Superbugs You've Never Even Heard Of

We don't think of hospitals as places where we can get sick. But that's what they are, far more commonly than the healthcare industry wants us to know.

Hospitalized for pneumonia, Lisa Thayer's mother was suddenly gripped with painful cramps and a bout of diarrhea that Thayer calls "explosive."

"It had a horribly distinctive smell -- a gross almost-sweetness that made me close my eyes. The hospital staff recognized it immediately," says Thayer, a Houston architect. "They said, 'Uh oh. It's C-diff.'"

Thayer had never heard of C-diff, aka Clostridium difficile: a potentially lethal colon-destroying bacteria. It spreads via fecal-oral contact. An infected person's feces contain bacteria that form sturdy disinfectant-resistant spores that can survive in the open for five months. A hand touches a contaminated surface, then enters a mouth. Think you're not eating shit? In hospitals, you quite possibly are.

According to a recent article in American Family Physician,13 percent of patients hospitalized for up to two weeks catch Clostridium difficile, as do 50 percent of those hospitalized for four weeks or more. But you needn't be a patient to catch C-diff. All you need do is visit a hospital.

Over the last decade, C-diff has morphed into a superbug. A new epidemic strain emerged in 2004 that is now making C-diff ever more virulent, drug-resistant, prevalent and lethal. The Centers for Disease Control estimates that C-diff kills nearly 30,000 people in America every year. Some experts call this a low estimate.

We think of hospitals as places where diseases go away, not as places where we can get sick.

But that's what they are, far more commonly than the healthcare industry wants us to know. In a crisis that costs American hospitals some $40 billion every year, millions of infections are contracted annually within these ostensibly sanitary institutions. Collectively, they're called hospital-acquired infections, nosocomial infections or HAIs. Patients face the gravest risk, but visitors are far from immune.

C-diff is the meanest new microbial kid on the block, but it's not the only one. Another hospital-dwelling superbug is methicillin-resistant Staphylococcus aureus, aka MRSA: a drug-resistant staph infection that is on the CDC's "high priority" list and kills about 18,000 every year in the US. Infection rates have skyrocketed since 1980 as MRSA evolves at warp speed, outsmarting antibiotics that now can't kill it. Contracted through cuts in the skin, MRSA can cause deadly bone, blood and organ infections. Nearly 90 percent of MRSA cases originate in hospitals.

Swing by to see Dad after his hip-replacement surgery, and you could catch something that ravages your bowels, causes flesh-eating pneumonia, and/or kills you.
Children, seniors and people with health problems -- especially those taking antibiotics or undergoing chemotherapy -- face the highest risk of contracting C-diff when visiting hospitals.

"But anyone can develop C-diff if the spores enter their mouth," says former New York State Lieutenant Governor Betsy McCaughey, who combats HAIs through her advocacy group, theCommittee to Reduce Infection Deaths. "Visiting a hospital recently, I saw a child in the elevator eating French fries and touching all the surfaces. I wished that I could explain to the parents that these invisible C-diff spores are on everything."

That is, everything that infected people's feces have touched. And those explosive, watery C-diff feces have a knack for traveling. We're talking walls, sinks, toilets, linens, light switches, furniture, wheelchairs, drapes, handles, knobs, telephones, trays, uniforms, buttons, doors and floors. Standard cleaning methods with alcohol and ammonia products won't kill C-diff spores; pretty much only bleach can.

"Don't bother using alcohol-based hand sanitizers," McCaughey warns. "They won't work. Wash with soap and water -- but even then, you're not killing the germs. Soap doesn't kill them. You're just washing them down the drain.

"Children are especially at risk of infection because when they visit Grandma in the hospital, they don't behave in risk-averse ways. They crawl on the floor. They pick things up and eat them. They touch everything. They're unaware that this is a very perilous environment."

Parents planning hospital visits "should leave their children home. Get a babysitter," McCaughey urges. To protect oneself as well as the patient and fellow visitors, she says, "bring a canister of bleach wipes and rubber gloves instead of flowers or fruit."

C-diff spores and other pathogens can cling to those gifts and cards that pile up in patients' rooms. McCaughey advises never touching these items and, if bringing someone home from the hospital, leaving gifts and cards behind.

"They're infected. Do you want to take those bugs home to your family?"

MRSA bacteria are hardy, too. According to one study, they can survive up to 56 days on polyester-cotton fabric and three months on plastic. Other studies found MRSA bacteria surviving a week on plain cotton fabric and two weeks on terrycloth.

Alcoholcankill MRSA bacteria, but that matters little if surfaces aren't scrubbed.

"Every hospital has a procedure for hygiene," says Lisa Thayer, who remembers watching in horror as an orderly who had just cleaned Thayer's mother opened an ostensibly sterile closet with clearly contaminated hands. "In some, staff are required to wash their hands for two minutes before entering a unit. How many people do you think wash their hands for two solid minutes? That's how these infections spread."

Another study found bacteria in 75 percent of the rooms of patients with MRSA, and on the uniforms of 65 percent of nurses who had performed procedures on patients with MRSA earlier that day. Shockingly, MRSA bacteria was also found on 42 percent of hospital personnel who had not even touched such patients, but had touched contaminated surfaces.

Don't hug the staff.

The HAI risk for hospital visitors "is a really important and underestimated issue," declares McCaughey, who says she once met a woman who had most of her hand amputated after contracting MRSA through a cut while visiting a sick friend.

McCaughey exhorts hospital administrators to enforce rigorous cleaning protocols and discourage children from visiting. She applauds the 27 state laws now on the books requiring hospitals to track and disclose their HAI rates. Delaware's Hospital Infections Disclosure Act, for example, penalizes noncompliant hospitals with fines and yanks their licenses.

"And shame on the CDC for not updating their statistics often enough to show people how bad this crisis really is. They can tell you how many people died last year of heart attacks and the flu, but not how many died of HAIs. That's just wrong. The CDC is not nearly as aggressive about this as it should be."

Picture this: While visiting Dad post-surgery, you sling your backpack over a chair, tap a wall, and/or open the curtains. Then before washing your hands, you idly chew your fingernail or lick donut crumbs off your thumb. It's enough to spawn paranoid fantasies -- which spring from virulent, if microscopic, grains of truth.

Visiting the sick is compassionate. In Judaism, it's considered a mitzvah: a good deed that helps enact tikkun olam, the process of repairing a shattered world.
Perform it at your own risk.

Anneli Rufus is the author of several books, most recently The Scavenger's Manifesto (Tarcher Press, 2009). Read more of Anneli's writings on scavenging at scavenging.wordpress.com.
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