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Hospital Infections Kill 48,000 Each Year

Study Shows Hospital-Acquired Infections Kill 3 Times as Many Americans as HIV

By Daniel J. DeNoon
WebMD Health News

Reviewed By Louise Chang, MD

Feb. 22, 2010 -- Every year, 48,000 Americans die of infections they caught while in the hospital -- and that's a conservative estimate, a new study finds.

These aren't infections people would have caught anyway. They are mistakes that cost lives, says study researcher Ramanan Laxminarayan, PhD, MPH, a senior fellow at the Washington, D.C. think tank Resources for the Future.

"It is a staggering number and one that does not have to be," Laxminarayan tells WebMD. "When a patient goes to the hospital for another illness and dies of pneumonia, it does not always occur to the family that it was a mistake. But if that same patient went to the hospital and got blood tainted with HIV, the response would be quite different."

Hospital acquired infections actually kill three times more Americans than HIV does. Yet we're only beginning to get a handle on the size of the problem. That's because it's been very hard to separate out the costs -- in terms of lives, suffering, and money -- from the suffering caused by the illnesses and injuries that land people in the hospital in the first place.

Laxminarayan and colleagues analyzed administrative data from a huge national database of information on hospital records for 69 million U.S. residents in 40 states between 1998 and 2006. They focused only on infections acquired in the hospital, and not on infections picked up in the community.

Most of the infections come from using catheters and ventilators. Some of the germs causing the infections have been around for years; others are scary new bugs such as the MRSA staph "superbug."

Johns Hopkins researcher Peter J. Pronovost, MD, PhD, is a world expert on hospital-acquired infections. He tells WebMD that the Laxminarayan study finally gives hard numbers to a problem that has vexed hospitals for decades.

"These deaths are invisible. The public doesn't know. They are happening one at a time, silently, and patients think they are inevitable," Pronovost tells WebMD. "But we know from our large patient studies this is not the case."

In a study reported earlier this month, Pronovost and colleagues showed that by instituting simple safety checklists for hospital procedures -- and by insisting on a team approach that includes the lowliest nurse assistants and the loftiest senior surgeons -- hospital infection rates can be dropped nearly to zero.

But it's not all up to hospital staff. You and your family can do a lot to prevent deadly hospital infections. Pronovost offers the following list. Note that some of these items may help you decide which hospital you should go to in the first place:

  • Ask your doctor the hospital's rate of bloodstream infections; it should be at or below one infection per 1,000 catheter days.
  • Ask if the hospital is participating in the national effort to prevent these infections - it should be.
  • Ask if they use the Pronovost checklist when inserting central line catheters.
  • Ask if the clinicians wash their hands each time they enter your room.
  • If you have a catheter, ask daily if you still need it. The catheter is a risk for infections

Pronovost says that while hospitals may have good intentions, it's essential they keep track of their hospital infection rate. If a hospital can't tell you its infection rate, it's not doing enough.

"It's like making a New Year's resolution to diet -- it doesn't work unless you step on the scales throughout the year," he says.

Now that the scale of the problem is known, Laxminarayan says that the U.S. should mount a prevention effort on the same scale as its anti-AIDS effort.

"People need to speak out," he says. "Nobody can argue that patients going to the hospital should be at minimal risk. Many of these infections can be prevented, and there is no good reason not to do that."

The Laxminarayan study appears in the Feb. 22 issue of Archives of Internal Medicine, as does an editorial by Pronovost. Pronovost's study appears in the Feb. 4 online edition of BMJ.

SOURCES: Eber, M.R. Archives of Internal Medicine, Feb. 22, 2010; vol 170: pp 347-353.

Murphy, D.J. and Pronovost, P.J. Archives of Internal Medicine, Feb. 22, 2010; vol 170: pp 353-355.

Pronovost, P.J. BMJ, published online Feb. 4, 2010.

Ramanan Laxminarayan, PhD, MPH, senior fellow, Resources for the Future, Washington, D.C.

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