Hospital Superbugs
Physician, wash thyself, and other medical safety tips
A killer began stalking infants at Westchester County Medical Center in Valhalla, N.Y., at the end of 1995. This was no ordinary assassin. It was a bacterium called vancomycin-resistant enterococcus, known to doctors as VRE, that lurks in hospitals. It can kill if left untreated. Few antibiotics can stop it. And babies were testing positive for VRE in the medical center's preemie ward.
This tale has a happy ending. No babies died from the bug. Hospital workers tracked down the bacterium to its source: Dirty diapers, weighed to measure waste output, were placed on the same scale as clean diapers. The hospital changed its procedure, and the VRE spread was halted.
The age of the hospital superbug has dawned. In hospitals across the country, the germs-in-residence are scoffing at some of the most potent antibiotics devised by science. And hospital patients are suffering as a result. People infected with germs resistant to proven drugs spend more time in the hospital recovering; an unlucky minority die. Hospital patients can protect themselves, but it takes some gutsy speaking up.
Doctors are understandably touchy about this subject. They point out that only the most critically ill patients--people with cancer, burn victims, premature infants, people dependent on ventilators or catheters--are at high risk of succumbing to superbugs. Most superbugs can still be killed by at least one antibiotic, and even the very sick tend to die not from infection but from the disease that landed them in the hospital in the first place. "We like people to take this issue seriously," says David Henderson, deputy director for clinical care at the hospital of the National Institutes of Health. "But it's not going to get everybody." And some of the most feared germs, such as the so-called flesh-eating bacteria, have not yet shown antibiotic resistance.
Still, for people in desperate shape, a superbug can be the final, fatal blow. One study found, for example, that 75 percent of patients with hospital-acquired VRE died. Doctors can help by being vigilant in infection-control procedures and giving antibiotics. But when conventional drugs are rendered impotent by the powerful bugs, physicians are often forced to give antibiotics that are perimental or have serious side effects.
The statistics are enough to make even a hypochondriac swear off hospitalization. Every antibiotic has lost its effectiveness against at least one form of infection that it used to control. Some 2 million Americans acquire infections in hospitals every year. Roughly half of those infections involve resistant germs. The nasty bugs that lurk in intensive-care units include:
Vancomycin-resistant enterococcus. VRE is an increasingly common bug that, once established in a hospital, is difficult to dislodge. Some forms are resistant to all standard antibiotics including (as the bacterium's name implies) the drug of last resort, vancomycin.
Pseudomonas aeruginosa. This germ, which resists a host of antibiotics, is especially dangerous to patients with cancer and cystic fibrosis. A superdrug, imipenem, that killed this superbug was developed in the 1980s. But it soon lost its power against many infections from this bacterium.
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