Deadly hospital infections are still too common

Deadly hospital infections are still too common

Many of the germs are far more common than Ebola, and some are nearly as dangerous

Published: November 15, 2014 06:00 AM
MRSA
About 11,000 hospital patients died of this infection in 2011.

The Ebola scare seems to be on the wane, at least in this country. The two nurses who contracted Ebola while caring for an infected patient at Texas Health Presbyterian Hospital Dallas have recovered, as has the New York City physician who returned from West Africa with the disease. And the Centers for Disease Control and Prevention has issued guidelines that could help hospitals handle suspected Ebola patients.

“But there are lots of reasons for patients to worry about other infections in hospitals besides Ebola,” says Lisa McGiffert, director of the Consumer Reports' Safe Patient Project. “Hospitals are breeding grounds for dangerous bacteria and viruses, many of them life-threatening, and hospitals often don’t do a good enough job of controlling them.”

Consumer Reports’ hospital Ratings, which includes information on more than 4,000 hospitals in all 50 states plus the District of Columbia and Puerto Rico, show that if you are admitted to a U.S. hospital, you’re at risk for dangerous infections that are far more prevalent than Ebola.

Infections are rampant

There were an estimated 720,000 hospital-acquired infections in U.S. in 2011, according to the CDC. That’s one in every 25 patients. Even more worrisome: 75,000 people a year die because of those infections. That’s more than 15 times the number of Ebola deaths reported worldwide this year.

The infections often develop during or after surgery, or can be traced to urinary catheters or central-line catheters, which are used to provide intravenous nutrition, fluid, and medication to seriously ill hospital patients.

Our hospital Ratings include information on each of those infections, and combine them into an overall infections Rating that reflects a hospital’s ability to prevent infections. It is worrisome that a third of the hospitals in our Ratings got our two lowest Ratings on that measure. 

"We know that hospitals can make changes to reduce infections and even drive infection rates to zero," says Doris Peter, Ph.D., director of the Consumer Reports Health Ratings Center. "By shining a light on hospitals' infection rates, consumers can find out which hospitals have done this successfully, and which ones have not."   

Only about 13 percent of hospitals, or 355 nationwide, got our highest overall infection Rating. And only 37 hospitals in the entire country got our highest Rating in preventing each of the infections we measure, meaning that they reported zero infections in surgical-site, urinary-tract, and central-line infections (see chart, below).

C. difficile
About 14,000 hospital patients died of this infection in 2011.

And the hospitals that do well in preventing infections aren’t always the most famous or prestigious ones. “The pathogens that cause infections don’t care about a hospital’s reputation or ad budget,” Peter says.

For example, Texas Health Presbyterian Dallas, which was at the center of the Ebola scare last month, has been called “the Neiman Marcus” of Texas hospitals because of its wealthy patient base. But it scored in the middle in terms of its ability to prevent infections.

Among the deadliest germs in hospitals is Clostridium difficile (C. diff), which took the lives of an estimated 14,000 people in 2011. It recently surpassed Methicillin-resistant Staphylococcus aureus or MRSA, a germ that can no longer be easily controlled by antibiotics and was linked to 11,000 deaths in 2011. Other bacteria are becoming more common, too, including carbapenem-resistant Enterobacteriaceae. It recently increased fivefold in community hospitals in the southeastern U.S., and was responsible for the deaths of 610 people in 2013.

U.S. hospitals that earned our top marks in preventing infections

The 37 hospitals listed below are the only ones in the country that got our highest Rating in preventing surgical-site infections, central-line infections, and infections stemming from urinary catheters. (Data is from April 2012 to March 2013.)

Why so many infections?

“It’s no secret what hospitals should do to prevent infections,” McGiffert said. “Studies have shown that when hospitals focus on preventing infections, they can stop them. It’s not complicated, but it takes an ongoing commitment to quality.”

Case in point: hand washing. “We’ve known for more than 100 years that washing hands prevents the spread of infections, but surveys of health care workers show that many still don’t properly or regularly even do this most basic of steps,” Peter said. “That’s frustrating and inexcusable."

What you can do

If you’re admitted to the hospital, follow these guidelines to lower your risk of developing an infection while you're there.

Check up on hand hygiene. Make sure that everyone who touches you, including friends and family, washes their hands first, or cleans them using an alcohol-based hand rub. If you don’t see them do that, ask them to.

Know how to care for your surgical wound. A wound that opens in the days following an operation is an infection waiting to happen. Ask how to care for your incision site and how long it should take to heal.

Prevent bloodstream infections. Central lines, used to deliver medicine and nutrients, should be kept clean and removed as soon as they’re no longer necessary. Ask daily if yours can be removed. If you can’t ask, have a friend or loved one speak up.

Limit the time you have a urinary catheter. Called a Foley catheter, this device is inserted if you can’t use a bedpan or the bathroom. The longer it stays in, the greater your risk for infection. Ask every day if you still need the device. And if you are able to use the bathroom or bedpan, say so. Also, make sure your provider washes her hands thoroughly with soap and water or an alcohol-based hand rub before and after touching the catheter.

—Catherine Winters


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