Hospital Infections And Drug Resistance Way Up In U.S.
By Mike Cooper
3-13-98
ATLANTA (Reuters) - The rate at which patients pick up an infection while
being treated in a U.S. hospital has increased 36 percent in the past 20
years, U.S. health researchers said Wednesday.
The number of patients who get an infection while in the hospital has remained
stable, even though fewer people are being hospitalized and their hospital
stays are shorter, Dr. William Jarvis of the Centers for Disease Control
and Prevention (CDC) told researchers at an international conference on
emerging infectious diseases. "Between 1975 and 1995, the nosocomial
(hospital-acquired) infection rate increased about 36 percent," Jarvis
said. He said the figure was based on discharge information from hospitals
across the country. "We estimate that today 2 million patients develop
a hospital-acquired infection in the United States each year. Of that number,
90,000 die as a result of those infections," Jarvis, acting director
of the CDC's hospital infections program, told Reuters.
There were 9.77 hospital-acquired infections per 1,000 patient-days in
1995, compared with 7.18 in 1975, Jarvis said. He said the rate had risen
in part because hospitals were using more invasive procedures -- using
breathing tubes and intravenous catheters, for example -- to treat patients.
"Those are lifesaving but carry a risk of causing a nosocomial infection,"
Jarvis said. Not only are hospital patients at increased risk for infection
but the infectious diseases are increasingly resistant to drugs commonly
used to treat them. "In at least 70 percent of the hospital-acquired
infections that occur, the organism is resistant to at least one antibiotic.
In 35 to 40 percent of infections, the organism is actually resistant to
the best drug you would use to treat that organism," Jarvis said.
Fred Tenover, also of the CDC's hospital infections program, said drug
resistance was an evolutionary process. "It is survival of the fittest.
You are the most fit if you are a bacteria and you are resistant to antibiotics,"
Tenover told the International Conference on Emerging Infectious Diseases,
sponsored by the CDC and the American Society for Microbiology. One of
the problems is that antibiotics are overprescribed, Jarvis said. A University
of Iowa study found that use of vancomycin, a first-line drug used to combat
serious staphylococcal and enterococcal infections, had increased 200-fold
but its use was unnecessary in almost two-thirds of those cases.
Overall, hospital infections could be reduced if health-care workers would
simply wash their hands more frequently, researchers said. "Patients
or their family members should stop that physician, stop that nurse, stop
the clinician before touching them and say, 'Have you washed your hands?'"
Jarvis said. Jarvis said there would have been an even larger increase
in infections if hospitals had not adopted infection-control programs during
the past two decades. "If they had not been in place, we would probably
have seen a 50 to 75 percent increase in infection rates," he said.
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