An Outbreak of Hospital Infection Talk

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In June of 2003 I had surgery to remove a stromal tumor from my stomach. The surgery was successful however my recovery was a nightmare. To this day I shudder at the thought of ever having to be a surgery patient again. What should have been a 2 day hospital stay and a quick recovery became a 10 day hospital stay and a 3 month recovery from a post-operative infection that nearly killed me. Within a few days my stomach became the size of a basketball..hard as a rock and hot to the touch. Ran a high fever and the antibiotics couldn't bring down my temperature. Low and behold after a week of suffering my surgeon finally decided to open my incision to release whatever he lurking inside. Upon trying to do so, nothing was coming out. I suggested that I sleep with a heating pad on my belly to activate things. He agreed and by the next day his associate was able to open the incision (my original surgeon was off that day). This was done in my bed..in my hospital room. Simple proceedure. What came "flying" out of my stomach was reminiscent of The Exorcist vomit scene. The most vile smelling green/yellow pus-like matter covered the area. The infectious matter was finally out of me but for the next 3 months I needed a nurse to come to my house to clean and pack the gaping hole that could not be re-sutured after the re-opening of it. I was told that I was one of the "lucky ones" that survived this type of ordeal. What really made me wake up to the reality of medical/surgical cover ups was the fact that I had to insist that the substance that flew out of my stomach should be cultured to find out what this mess that nearly killed me was composed of. Reluctantly it was done and I was told it was strep bacteria along with another bacteria form that they were not familiar with. I did not pursue it because I was just thankful to finally be free of the agony I suffered for much too long. I was happy to be going home. I know that there are many people out there who have gone through this type of ordeal and worse: I truly sympathize with them and their families. Now I just have to hope that the tumor never returns. If it does I choose not to repeat any surgery. I was, and still am, traumatized by my brush with death. When my time comes to bid the world adieu, I don't want it to happen because of some careless doctor at a clueless hygiene-lacking hospital with little or no knowledge of how to keep patients safe. Thank you to who ever might take the time to read about my experience. It helps me to write about it but even more important..my advise to you. If you need to be hospitalized for surgery or any other condition..BE INFORMED..INVESTIGATE THE FACILITY FULLY..KNOW THAT THE HELP FOLLOWS HYGIRNE RULES..IF ANY..ASK QUESTIONS...MOST OF ALL...BEWARE!!!!!!!!!!!

ILA DAVIS GREENSPAN of IL 3:56PM November 16, 2008

Washing hands,a good infectious disease team ,and good hygiene do contribute to preventing hospital infections.The overuse of some antibiotics can and will often increase infections such as MRSA, C,difficelle and other infections. With goood survailence, reporting of infections ;IV catheter, and other infections after hospital procedures can be prevented.

John Tarnann Microbiologist of OH 4:55AM October 09, 2008

Infections in hospital are an ongoing problem.With goods survailance ,such as an infectious team, often times outbreaks of such organisms,MRSA staph,new emerging strains of enterococcus resistant to vancomycuin,are emerging. with a possibility of staph resistant vancomycin, which is often times the last antibiotic of choice given by IV(intravenous veins).The IV's used with antibiotics, can significantly decrease the infections ,if used prophylactically, before and after surgeries or other invasive procedures. However, other resistant strains of other organisms for example,Ecoli, streptococi,and etc. develope to these antibiotics with the overuse of antibiotic ,because out of the millions of orgnisms ,a very few still often times become resistant ,and multiply as
resistant strains.The medical technologist then needs to isolate, and identify the pathogenic, disease, and identify antibiotics that the physician, and the infectious disease specialist, can often times recomend the best antibiotic which is effective and the dosage needed. Catheters often times move,and need to be changed on a shedule, to reduce these infections. Other types of specimens are collected to rule out possible pathogens that cause diseases. Again ,with good Quality Control,and with excellent communications to the infectious disease team ,consisting of doctors ,nurses and other specialists, infections can be prevented and reduced.Hand washing, along with good hygiene for example,not coughing without covering ones mouth using a mask ,sterile gloves for in hospital medical procedures can and does significantly reduce infections.C.dificele is caused by overuse of antibiotics, and poor environmental disinfection, hand washing techniques not obseved or not using sterile gloves and perhaps other methods that may in the future reduce these hospital aquired infections.

John Tarmann microbiologist (MTASCP)medical technologist of OH 4:17AM October 09, 2008

Failed health care leadership has brought us legions of victims and now, in response to a popular uprising of consumers and consumer advocates, those responsible for the decades old epidemic want to appear as though they are appropriately responding to a relatively new and ever changing crisis.
But they are not. It's politics instead of leadership, PR instead of an appropriate response, and protectionism from the usual suspects. CMS is right in using the money lever (although not enough) and consumers will continue to increase the pressure.
And Jeanine Thomas is right, legislation, it seems, is the only solution.

Michael Bennett of MD 6:10PM October 08, 2008

We've actually reduced most of our infections and have MANY months where we are at ZERO. Most hospitals GET IT and are concentrating their effort to get to zero infections.

jjharris of WA 11:01AM October 08, 2008

I agree, we know what to do to prevent infections. And Mr. Comarow is correct, physicians do not always know or follow the guidelines. Until hospital CEOs provide the support and resources to change the culture of "everyone doing their own thing," improvement will be slow. CEOs are caught between the rock of keeping costs down- after all, hospitals, even non-profits, have to make money to invest in new technology, hire people etc.- and providing the products like impregnated catheters, that are so much more expensive. (A new, silver-coated endotracheal tube is over $100, regular ones are under $5. Sadly, it has taken the threat of CMS reimbursement reductions to get the attention of many of these CEOs. They don't understand that quality pays. But it is even more complex. The majority of nurses are 2 year grads who don't have the necessary knowledge and skills, most work part-time, and the work ethic just isn't there. Obviously, this is not ALL nurses, but certainly a lot. Hospital facilities are aging and small rooms barely accommodate the larger beds and all the equipment needed in a modern facility- making access to the sink problematic. This is not a simple problem that has a quick fix, but this collaborative announcement will help the momentum of the infection prevention movement.

Marcia Patrick of WA 9:07AM October 08, 2008

When doctors had only a little black bag and a lot of common sense, they went to where the patients were and their best weapon against infectious diseases and infections in general was quarantine.
Burning the clothing and isolating the patient from the community until the danger of spreading the disease or infections was past.
Today, the sick, diseased and infected all gather at the doctor's office, clinics, hospital emergency rooms where the overcrowding of all of the above are perfect breeding grounds for speading the infectuous diseases.
The best weapon they have come up with so far to prevent the spreading is soap and water and cold (these places are murder on arthritic sufferers).
The assembly line tactics that worked so well for producing affordable automobiles is not the best tactic for dealing with such diseases and infections by the medical profession. But it is the most economical and profitable way for them to handle patients.

HillbillyBill of TN 8:08AM October 08, 2008

We have all been in a hospital or urgent care or emergency facility in our lifetime, or most likely will entcounter them.If not, perhaps we where a visitor to a doctor or even had an immunization.Useing good hand washing techniques is so critical to reducing hospital aquired infections,such as MRSA staph,steptococal pneumonias,viruses,fungii,and tubercular T.B. like infections.Recently, it was confirmed,for example,that viruses were the cause of HIV(human imunovirus)or aids.There also are links between various forms of viruses and human and other cancers.Fortunatily these are not all easilly transmited casually between hosts, or people. Many infections can be prevented by good hygiene, especially good and repeatable handwshing techniques.Whenever you encounter an individual caregiver ,such as a doctor, nurse or other medical care givers encourage without being threatening them to either wash their hands or change their gloves between patients especially you.A task as simple as washing hand washing routienly ,can prevent the spread of infections.It is understood that in a fast paced medical practice of any type, this can often be forgotten. There are however surviallance type people, refered to as infectious disease individuals, who are very effective in reminding this, as a quality control for the purpose of reducing infectiond along with inservice seminars or simple signs. Often disinfectant solution dispensers are placed in strategic locations to facillitate these methods. Pastuer in the 1800's first saw microbes under a microscope , he designed, I believe,to see things he believed could be causing a large death rate in a obgyn floor in paris about that time. Therefore he had hospital personel boil hospital sheets and clean the environment. He also required them to wash their hand thouroughly,before and after any obgyn prodedures such as births. With these methods he reduced the death rate not only of the newborn, but also of the mothers significantly The most likely culpret micrope,was probably listeria monocytogenes,a common even today . He is the first infectious disease scientist to realize that small objects he saw swimming about under the microscope where the agents that caused these infections.After publishing many journals and contributing so much, he is considered the pioneer of microbilogy, the study of microbes.Today many doctors, nurses ,and especially medical technologist identify the microbe and set up sensitivities ,which tell the doctor , who orders not only the antibiotic but the dose amount of the antibiotics to erradicate the infectious microbes in patients. Today thanks to the CDC,center for disease control, many infections are kept in check preventing epidemics, or the spread of disease Worldwide. New supermicrobes are still a problem overusing antibioticss.

John Harold Tarmann (MTASCP)microbiologist of OH 1:49AM October 08, 2008

Talk, talk, talk, that is what has gone on for decades. Or the other mode of distraction is, "we need to study it some more"! Entire nations have controlled MRSA and other MDRO's to low levels, yet we ignore that and continue doing the same thing over and over, as the mounting number of preventable deaths and needless pain and suffering continue - day in and day out. There are over 160 studies that show screening for MRSA with isolation controls MRSA, yet the powers to be ignore that. Well, lawmakers have not - driven by patient and consumer advocates, now five states have passed mandated screening for MRSA of at-risk patients. The vacuum of leadership by the infection control powers to be has left them irrelevant and patient advocates along with lawmakers are getting the job done by legislation and educating the public, which is saving lives.

Jeanine Thomas of IL 4:29PM October 07, 2008

One central line bundle component I seldom read about is technology. I have seen several studies showing that antibiotic and antimicrobial catheters and devices dramatically reduce infection rates. I'm aware of no study showing they don't work. The debate seems to be technology vs. bundles. Why not apply the best available tools, in all forms? Technology is not a substitute for common sense behaviors but if the catheter is antimicrobial, one might expect a level of protection even if the physician forgot to wash his or her hands. Drum brakes work fine if you can control weather, road conditions and the behavior of the driver next to you. Without such control, the disc brake often proves helpful. The same can be said for the passenger airbag. Patients should not be put at unnecessary risk while hospitals strive for uncompromising, and potentially unrealistic, process reliability.

bruce gingles of IN 4:03PM October 07, 2008