CDC Reports: Hospital Infections
and Drug-resistance Rise in U.S.

This section is compiled by Frank M. Painter, D.C.
Send all comments or additions to:    Frankp@chiro.org

By Mike Cooper

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ATLANTA (Reuters) - The rate at which patients pick up an infection while being treated in a U.S. hospital has increased 36 percent in the past 20 years, U.S. health researchers said Wednesday.

The number of patients who get an infection while in the hospital has remained stable, even though fewer people are being hospitalized and their hospital stays are shorter, Dr. William Jarvis of the Centers for Disease Control and Prevention (CDC) told researchers at an international conference on emerging infectious diseases.

``Between 1975 and 1995, the nosocomial (hospital- acquired) infection rate increased about 36 percent,'' Jarvis said. He said the figure was based on discharge information from hospitals across the country.

``We estimate that today 2 million patients develop a hospital-acquired infection in the United States each year. Of that number, 90,000 die as a result of those infections,'' Jarvis, acting director of the CDC's hospital infections program, told Reuters.

There were 9.77 hospital-acquired infections per 1,000 patient-days in 1995, compared with 7.18 in 1975, Jarvis said. He said the rate had risen in part because hospitals were using more invasive procedures -- using breathing tubes and intravenous catheters, for example -- to treat patients.

"Those are lifesaving but carry a risk of causing a nosocomial infection," Jarvis said. Not only are hospital patients at increased risk for infection but the infectious diseases are increasingly resistant to drugs commonly used to treat them.

"In at least 70 percent of the hospital-acquired infections that occur, the organism is resistant to at least one antibiotic. In 35 to 40 percent of infections, the organism is actually resistant to the best drug you would use to treat that organism," Jarvis said.

Fred Tenover, also of the CDC's hospital infections program, said drug resistance was an evolutionary process. "It is survival of the fittest. You are the most fit if you are a bacteria and you are resistant to antibiotics," Tenover told the International Conference on Emerging Infectious Diseases, sponsored by the CDC and the American Society for Microbiology.

One of the problems is that antibiotics are overprescribed, Jarvis said. A University of Iowa study found that use of vancomycin, a first-line drug used to combat serious staphylococcal and enterococcal infections, had increased 200-fold but its use was unnecessary in almost two-thirds of those cases.

Overall, hospital infections could be reduced if health- care workers would simply wash their hands more frequently, researchers said. "Patients or their family members should stop that physician, stop that nurse, stop the clinician before touching them and say, 'Have you washed your hands?' " Jarvis said.

Jarvis said there would have been an even larger increase in infections if hospitals had not adopted infection-control programs during the past two decades. "If they had not been in place, we would probably have seen a 50 to 75 percent increase in infection rates," he said.

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