Las Vegas Sun

December 19, 2014

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Sun Editorial:

A spreading danger

Hospitals should do more to protect patients from deadly bacteria

Today’s stories by Sun reporters Marshall Allen and Alex Richards about patients who have become infected by lethal, drug-resistant bacteria during stays in Las Vegas Valley hospitals should serve as a wake-up call to those medical facilities that more needs to be done to improve patient safety. The rate of patients who contracted the contagious bacteria known in shorthand as MRSA rose by 34 percent in area hospitals from 2008 to 2009.

State records available before 2008 do not indicate whether patients were infected in the hospital or had the infection when they were admitted. But the records show that 2,010 patients were infected with MRSA and Clostridium difficile, better known as C. diff, while hospitalized during the two-year period for which records are available, providing enough evidence to indicate a widespread problem that warrants immediate attention.

As Nevada State Epidemiologist Dr. Ihsan Azzam told the Sun: “Such a significant increase in these rates coupled with the threat of emerging resistant organisms in the health care setting should sound the alarm for all clinicians, hospitals, infection-control specialists and epidemiologists.”

One patient, 74-year-old Darwyn Lepper, died of infections months after undergoing hip surgery in 2008 at a local hospital. Why was that allowed to happen?

The possible answers are unsettling. Registered nurse Christina Schofield said she has witnessed poor infection-control practices everywhere she worked in Las Vegas over the past 23 years. Among the most egregious of these practices are when patients with contagious infections are placed in rooms with uninfected patients, rooms are not adequately cleaned between patient stays and medical professionals fail to wash their hands. Schofield called it “a multisystem failure.”

There is no excuse for such shoddy practices. Patients have every reason to expect that when they visit a hospital, it will be clean and safe.

Although the hospitals did not dispute the Sun’s findings, University Medical Center, to its credit, was the only area hospital willing to discuss them. Dr. Alan Greenberg, medical director of UMC’s infectious disease program, said the failure to follow hand-washing rules is a consistent problem.

The other hospitals, speaking only through their trade group, the Nevada Hospital Association, said they adhere to national standards intended to prevent the spread of bacteria among patients. This is troubling because it tells us either that the national standards are deficient or that hospitals have not been as careful as they say they have been at trying to stop the spread of infections acquired in their facilities.

If the problem lies with the national standards, the appropriate medical associations should make the necessary revisions so hospitals are employing the best known practices to prevent infections. Otherwise, the onus is on hospitals to take corrective action.

It is worth mentioning that some hospitals, including those run by the Veterans Affairs Department, have zero-tolerance policies for the spread of infections in their facilities. This is the right policy that should be followed by all hospitals in this country.

No miracle drug can wipe out MRSA or C. diff the way that penicillin was once used to defeat the deadly Staphylococcus aureus bacteria. MRSA and C. diff are more drug-resistant, which is why their presence has reached epidemic proportions. Hospital-acquired infections cost $30 billion annually and lead to the deaths of an estimated 100,000 people a year, making them among the nation’s leading causes of death.

Given those statistics, it is perplexing that no health agency tracks these cases. It is equally disturbing that Las Vegas Valley hospitals were successful last year in killing proposed state legislation that would have required them to publicly report the incidence of MRSA in their facilities.

Because area hospitals have struggled to keep Southern Nevadans from seeking medical care out of state, one would think they would be doing everything possible to build public trust in their facilities.

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