Every year, an estimated 648,000 people in the U.S. develop infections during a hospital stay and about 75,000 die, according to the Centers for Disease Control and Prevention (CDC). The latest hospital ratings are included in the report, “How Your Hospital Can Make You Sick.”

For the first time, the report includes information about two common and deadly infections: MRSA (methicillin-resistant staphylococcus aureus) and C. diff (clostridium difficile). This is the second piece in a three-part investigative series from Consumer Reports focused on America’s antibiotic crisis.

"High rates for MRSA and C. diff can be a red flag that a hospital isn’t following the best practices in preventing infections and prescribing antibiotics," said Doris Peter, Ph.D., director of Consumer Reports’ Health Ratings Center, in a statement. "The data show it is possible to keep infection rates down and in some cases avoid them altogether."

MRSA infections claim the lives of more than 8,000 patients each year in the U.S. and sicken almost 60,000. C. diff is even more prevalent. Each year, about 290,000 Americans develop a C. diff infection in a hospital or other health care facility and at least 27,000 of them die, according to the CDC.

To develop ratings for MRSA and C. diff, Consumer Reports analyzed information hospitals reported to the CDC. The MRSA and C. diff ratings are now part of Consumer Reports’ hospital ratings, which also include central-line associated blood stream infections, surgical-site infections and catheter-associated urinary tract infections. These scores, in addition to the new data for MRSA and C. diff, make up a larger composite infection score for individual hospitals.

To earn Consumer Reports’ very top rating in preventing MRSA or C. diff, a hospital had to report zero infections — 322 hospitals across the country were able to achieve that level in the MRSA Ratings, and 357 accomplished it for C. diff. Hospitals distinguish themselves when they earn high ratings against both infections —105 did that.

Several high-profile hospitals got lower ratings against MRSA, C. diff, or both, including the Cleveland Clinic, Johns Hopkins Hospital in Baltimore, Mount Sinai Hospital in New York and Ronald Reagan UCLA Medical Center in Los Angeles.

Only nine hospitals received higher ratings in avoiding not only MRSA and C. diff infections but also for avoiding the other infections included in Consumer Reports’ Ratings. They include Northwest Texas Healthcare System in Amarillo, Texas; Jupiter Medical Center in Jupiter, Fla.; White County Medical Center in Searcy, Ark.; Centennial Hills Hospital Medical Center in Las Vegas, Biloxi Regional Medical Center in Biloxi, Miss.; Johnston Memorial Hospital in Abingdon, Va.; Lima Memorial Health System in Lima, Ohio; Western Arizona Regional Medical Center in Bullhead, Ariz.; and South Baldwin Regional Medical Center in Foley, Ala.

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There was a 46 percent decrease in central line-associated bloodstream infections (CLABSI) between 2008 and 2013, according to a report recently released by the Centers for Disease Control and Prevention in Atlanta. However, additional work is needed to continue to improve patient safety, the annual National and State Healthcare-associated Infection Progress Report shows.

CDC’s health care-associated infections (HAI) progress report details how each state and the country are doing in eliminating six infection types that hospitals are required to report to CDC. For the first time, this year’s HAI progress report includes state-specific data about hospital lab-identified methicillin-resistant Staphylococcus aureus (MRSA) bloodstream infections and Clostridium difficile (C. difficile) infections.

The CDC report provides an update to previous reports detailing progress toward the goal of eliminating HAIs. The report summarizes data submitted to CDC’s National Healthcare Safety Network (NHSN), a health care-associated infection tracking system, which is used by more than 14,500 health care facilities across all 50 states, Washington, D.C., and Puerto Rico. On any given day, approximately one in 25 U.S. patients has at least one infection contracted during the course of their hospital care.

“Hospitals have made real progress to reduce some types of health care-associated infections – it can be done,” said CDC Director Tom Frieden in a statement. “The key is for every hospital to have rigorous infection control programs to protect patients and health care workers, and for health care facilities and others to work together to reduce the many types of infections that haven’t decreased enough.”

Although the latest CDC report didn’t cover it, the majority of C. difficile infections and MRSA infections develop in the community or are diagnosed in health care settings more than hospitals. Other recent reports on infections caused by germs such as MRSA and C. difficile suggest that infections in hospitalized patients only account for about one-third of all the health care-associated infections.

The CDC says that when health care facilities, care teams and individual doctors and nurses are aware of infection control problems and take specific steps to prevent them, rates of targeted HAIs can decrease dramatically. For example, increased attention to the prevention of catheter-associated urinary tract infections resulted in a reversal of the recent increase seen in these infections.

“Health care-associated infection data give health care facilities and public health agencies knowledge to design, implement and evaluate HAI prevention efforts,” said Patrick Conway, deputy administrator for innovation and quality and chief medical officer of the Center for Medicare & Medicaid Services, in a statement. “Medicare’s quality-measurement reporting requires hospitals to share this information with the CDC, demonstrating that, together, we can dramatically improve the safety and quality of care for patients.”

The HAI progress report can be found on the CDC’s website.

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The bacteria, carbapenem-resistant Enterobacteriaceae (CRE), have increased fourfold over the past decade from 1.2 percent in 2001 to 4.2 percent in 2011. In the first half of 2012, 200 health care facilities (18 percent of long-term acute care hospitals and 4 percent of short-stay hospitals) treated patients with CRE. And facilities in 42 states have reported at least one case of CRE.

While infections are uncommon, the bacteria pose what CDC Director Thomas Frieden called a “triple threat.” The bacteria are resistant to antibiotics; they kill up to half of patients who get bloodstream infections from them; and they can transfer their antibiotic resistance to other bacteria within the family, possibly making other bacteria also untreatable. Almost all CRE infections occur in patients that receive care for serious conditions.

The germs spread from person to person, usually on the hands of health care professionals. The CDC said the spread of CRE can be controlled using standard infection control precautions, such as washing hands and having dedicated staff, rooms and equipment to care for patients with CRE. The CDC also requires health care facilities to inform each other when they are transferring a patient with CRE and suggests asking patients about recent medical care elsewhere, especially in other countries. Prescribing antibiotics wisely can also reduce the problem because the fewer antibiotics are used, the less likely that antibiotic resistance will occur. Check more info here: https://antibioticstore.online/

As of now, the bacteria have not spread to the wide community, but if they do, the situation would be much more difficult to control, according to the CDC.

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The bill (S-1464), sponsored by Senate Health, Human Services and Senior Citizens Committee Chairman Joseph F. Vitale, would make it mandatory for state-licensed health care facilities, such as hospitals, nursing homes and home health care agencies, to start an annual influenza vaccination program. It would require each facility to provide either on- or off-site flu vaccinations to each health care employee, unless the worker provides documentation of a current flu vaccination or signs a document declining the service. Plus, the facilities would have to keep record of influenza vaccinations for each of its employees.

Another part of the program would include education to inform employees about the benefits of flu vaccines, non-vaccine flu control measures, and the symptoms, transmission and potential impact of the flu. The bill would also make it so that the facilities would need to conduct an annual review of the program. The only way that a health care facility would be able to stop the annual service would be if there was a determined shortage of available vaccines by the Commissioner of Health and Senior Services.

“A flu shot is simply the best and easiest way to prevent against getting and spreading the flu,” Senator Vitale said in a statement. “For those individuals, such as health care workers, who work closely with people who are sick and elderly, this is not about just protecting themselves, but about protecting those who are most vulnerable to the illness. In 2011, more than 50,000 people died from the flu, with a disproportionate amount being over the age of 65 or with chronic health conditions — the type of people who frequent medical facilities. For the protection of the patients and of health care employees, health care facilities such as hospitals and nursing homes have a professional and ethical responsibility to provide access to this vaccine.”

According to the Centers for Disease Control and Prevention, only 66.9 percent of health care workers received an influenza vaccine during the 2011 to 2012 flu season, but those that did not get a vaccine could pose a threat to patients with weakened immunities. For example, during the 1991 to 1992 flu season, a New York nursing home had an influenza outbreak in which 65 of the residents became infected: 34 of those cases turned into pneumonia, 19 residents were hospitalized and two died because of influenza-related causes.

The bill will now head to the full Senate for consideration.

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The campaign, led by the CDC and the Safe Injection Practices Coalition (SIPC) is meant to raise awareness for patients and health care providers about safe injection practices.

Since 2001, more than 150,000 U.S. patients have been notified of possible exposure to hepatitis B virus, hepatitis C virus and HIV as a result of errors in basic infection control practices — most of which involved health care providers reusing syringes and contaminating medication vials used on the since-notified patients, according to the campaign website. These exposures are linked to increasing outbreaks, including the more than 700 patients that were possibly exposed to all three viruses from insulin pens used at a Buffalo, N.Y., veterans hospital, as reported by The Washington Post earlier this month.

The campaign goal is to guarantee that patients are protected every time they receive a medical injection. In doing so, they plan to empower patients and re-educate health care providers on safe injection practices by raising awareness about the topic and encouraging both patients and providers to insist on nothing less than the campaign’s “one needle, one syringe, only one time” slogan — reducing the chance of infection.

Perhaps the biggest opponent to the campaign is the green health care supporters, who are looking to eliminate the amount of medical waste produced — about 7,000 tons a day or 2.5 million tons annually, according to Newsweek. While they’re not supporting the reuse of needles, they do believe that safely resterilizing medical equipment is the best way to reduce hospital waste.

Health care equipment, such as bronchoscopes and endoscopes, is too expensive to throw away after each use, but the reuse of it requires heavily regulated sterilization procedures. In the near future, the same caution and regulations will likely be put into place for more medical equipment as a result of the campaign.

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