Hospital "nosocomial" infections

        A Veterans Administration hospital in Pittsburgh has performed research and instituted new procedures that are shedding new light on the subject of hospital infections.  When you gather many ill people under the same roof and then create openings in their protective skin-covering, infection is a signficant and deadly concern.  It has long been recognized that many patients actually acquire infections in the hospital, and studies show that such infections occur more commonly in tertiary care or regional referral hospitals than in community hospitals.  Thus, part of the problem is not merely cleanliness and proper procedures:  part of the problem is the relative illness of the patient-base.  It has been more-or-less assumed that these infections cannot be eliminated or controlled and that nothing can be done to prevent the spread of antibiotic-resistant germs that may thrive in hospital settings.

        The work done at the Pittsburgh VA in conjunction with the Centers for Disease Control and Preventation,  however, shows that the 1.7 million nosocomial infections that occur in the U.S. each year can be controlled.   Data shows that one of every 22 hospitalized patients develops infection and 99,000 of these patients die each year.  The recent studies have focused on the benefits derived from active screening and isolation of incoming patients, combined with "a relentless focus on hygiene".  At the VA Hospital, this reduced the number of methicillin-resistant Staph infections from more than 60 per year to only 17.  The 40-bed surgical unit cut its infection rate by 78 percent.  Several European studies have documented similar results and Netherlands and Finland have virtually eliminated methicillin-resistant Staph through similar efforts.

        Eighteen states now require hospitals to disclose their infection rates publicly, however, citizens in most states, including Michigan, do not have access to this information.  Further, it is very hard to pursue a malpractice claim arising out of a nosocomial infection because many health care providers consider them to be unavoidable.  The theory goes like this:  "If it can happen without 'fault', and you can't prove our rate of occurrence or the procedures we follow, you can't prove that it happened to this patience because of our negligence."  This argument is effective in Michigan and many other states. 

        Betsy McCaughey, New York's former Lieutenant Governor, noted the irony in the fact that most hospitals screen for HIV on admission, but not for bacterial infections, despite the fact that bacterial infections account for SEVEN TIMES as many deaths as HIV and the annual cost of treatment runs in the tens of billions of dollars, nationally.  Apparently, HIV just sounds scarier.