Hospital-Acquired Infections, MRSA, Killed 48,000 Americans In One Year
A report on what has been described as the largest nationally representative study to date of deaths due to sepsis and pneumonia, appears in the 22 February issue of Archives of Internal Medicine.
Co-author Dr Ramanan Laxminarayan, who is leading Extending the Cure, an investigation into antibiotic resistance for the Washington DC based think-tank Resources for the Future, told the press that in many cases the conditions could have been avoided with better infection control in the hospitals.
"Infections that are acquired during the course of a hospital stay cost the United States a staggering amount in terms of lives lost and health care costs," said Laxminarayan.
"Hospitals and other health care providers must act now to protect patients from this growing menace," he urged.
The researchers said that hospital-acquired infections are caused by "superbugs", germs that can't be killed with common antibiotics.
Co-author Dr Anup Malani, a professor at the University of Chicago who is also working on Extending the Cure with Laxminarayan, said:
"These superbugs are increasingly difficult to treat and, in some cases, trigger infections that ultimately cause the body's organs to shut down."
Sepsis, a condition where the whole body goes into a state of inflammatory response, and pneumonia, an infection of the lungs and respiratory tract, are two conditions often caused by deadly microbes, including resistant bacteria such as MRSA (methicillin-resistant Staphylococcus aureus). Such infections usually lead to longer stays in hospital and can lead to serious complications and even death.
Laxminarayan and his colleagues examined data from 69 million records of patients discharged from hospitals in 40 states of the US (they used the Nationwide Inpatient Sample database).
The US Centers for Disease Control and Prevention (CDC) estimated in 2002 that 99,000 American deaths a year were linked to hospital-acquired infections. In this study the researchers focused on only the two most serious conditions, sepsis and pneumonia, and calculated deaths resulting directly from infections patients acquired while they were in hospital. Plus they concentrated on infections that they regarded as mostly preventable, such as when they result from a lapse in sterile technique during surgery.
They found that the cost of such infections can be high. For instance, developing sepsis after surgery resulted in an average of 11 extra days in hospital and an additional infection treatment cost of 33,000 dollars per patient.
However, the most alarming finding was that nearly 20 per cent of people who developed sepsis following surgery died as a result of the infection.
Malani, described this finding as a "tragedy" because:
"In some cases, relatively healthy people check into the hospital for routine surgery. They develop sepsis because of a lapse in infection control - and they can die."
When they looked at pneumonia, which can develop when disease-causing germs get into the lungs, for instance via a dirty ventilator tube (a clearly preventable post-surgery infection, as many are, said the authors), they found people who developed the condition after surgery stayed on average an extra 14 days in hospital at an additional treatment cost of 46,000 dollars per person. And in 11 per cent of cases the patient died as a result of the infection-related pneumonia.
"The nation urgently needs a comprehensive approach to reduce the risk posed by these deadly infections."
"Improving infection control is a clear way to both improve patient outcomes and lower health care costs," he added.
"Clinical and Economic Outcomes Attributable to Health Care-Associated Sepsis and Pneumonia."
Michael R. Eber; Ramanan Laxminarayan; Eli N. Perencevich; Anup Malani.
Arch Intern Med, Vol. 170 No. 4, February 22, 2010, pp 347-353.
Source: Burness Communications.
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