August 18, 2011


A Health Care Scourge We Can Eliminate Now (James K. Glassman, Jul. 21 2011 , Forbes)

At a time when health care costs are soaring and the health system is under enormous pressure to reduce expenditures, HAIs are an obvious target. Sometime in the future, we may be able to find a cure for pancreatic cancer or Alzheimer's, but right now we have the tools to attack the infections that are killing tens of thousands in hospitals.

The sources of those infections are well-known. They include "indwelling" medical devices such as catheters, the transmission of communicable diseases between patients and health care workers, and the overuse or improper use of antibiotics.

"There's no silver bullet" that can eliminate HAIs, wrote Mark Chassin, president of the the Joint Commission, a nonprofit that accredits health care organizations and programs, and Edward Ludwig, chairman of BD, a large medical technology company. But employing a series of best practices can lead to success, they say. It's up to the private sector and government to mobilize the solutions.

Start with the main problem. The World Health Organization has found that three-fifths of HAIs are caused by drug-resistant bacteria. These culprits are causing urinary tract and bloodstream infections and pneumonia.

The trick is to find quickly which antibiotics work and don't work. If bacteria are resistant to an antibiotic, they allow patients to be infectious longer. And these infectious patients spread resistant bacteria to other patients in a hospital setting.

Technology is providing some effective answers. Electronic clinical surveillance systems allow doctors to identify drug-resistant bacteria in patients quickly and stop infections before they get out of hand. One such example, Hospira's TheraDoc Platform, pioneered the technology at Johns Hopkins University Hospital in 2003, and now the software is in use at the Mayo Clinic and about 300 other institutions.

Pennsylvania implemented a mandatory reporting program for HAIs that included such surveillance systems and found that in 2009 HAI rates dropped 12.5% at the state's acute-care hospitals.

A major success story is the Veterans Affairs Pittsburgh Healthcare System, which, working with the CDC, cut MRSA infections by 60%. MRSA, or methicillin-resistant staphylococcus aureus, is caused by a strain of staph bacteria that's resistant to the antibiotics typically used for treatment.

How? CDC Director Frieden cites measures that include "strict attention to hand hygiene, enhanced surveillance for infections, effective use of isolation rooms, and behavior modification techniques for healthcare workers to emphasize the importance of the new procedures."

Posted by at August 18, 2011 7:07 AM

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