By Dr. Mercola
Hospitals have become particularly notorious for spreading lethal infections. But a recent report suggests these deadly bacteria may have an accomplice: “medical apathy” may be a secret plague in today’s healthcare system.
A report on Vox1 reveals many hospitals are essentially ignoring rising rates of central line infections — which are often lethal — passing them off as “unavoidable medical risks.”
Millions of central line catheters are inserted each year. Because they run straight to the heart, central lines are the fastest, most effective method of delivering some medications, but they’re not without serious risks.
If bacteria manage to get into a central line, such as when a nurse changes a dressing or injects a medication, they can easily create a bloodstream infection. At best, these infections cause suffering for already-sick patients, and at worst they’re lethal.
The way many hospitals respond to their mistakes is as tragic as the mistakes themselves.
Hospitals tell victims’ families they’re not responsible for the sad but “inevitable complications” of these risky medical procedures. This might be a plausible explanation... except that a few hospitals have proven it false!
More Than 250,000 Central Line Infections Occur Every Year
Central line-associated bloodstream infections (CLABSI) are the most common cause of health care-associated infections of the bloodstream. A single incident of CLABSI can add $56,000 to your hospital tab — although you might not live long enough to see the bill.2
Between 12 and 25 percent of patients who acquire CLABSI never make it out of the hospital. Each year 250,000 central lines become infected, accounting for an estimated 62,000 hospital deaths in the US.
Hospitals Should Be Less Like the Auto Industry, More Like the Airline Industry
Vox draws a parallel between the medical industry and the auto industry, in terms of how they view their role in adverse events. This is an appropriate analogy as these central line infections kill TWICE as many people every year as car accidents in the US.
Auto companies don’t view car crashes as their own failure, but as the inevitable failure of drivers — they view crashes as an unavoidable risk, the cost of operating a motor vehicle. This is vastly different from how the airline industry views plane crashes.
When a plane crashes, the airline assumes something went wrong and endeavors to fix every plane that will ever fly again. What would happen if the medical industry adopted this approach to central line infections?
Some have! And their line infection rates have fallen dramatically, even dropped to zero. A few hospitals are regarding each and every line infection as their own personal failure that requires investigation and “repair.”
Preventing Central Line Infections in Five Simple Steps
Peter Pronovost and colleagues at Johns Hopkins University created a simple five-item checklist that focuses on meticulous cleanliness when inserting and operating a central line and changing the dressing.
Upon observation of his colleagues, Pronovost found that physicians were following these steps only 30 percent of the time. Once they began to consistently implement all five steps, infection rates fell by 70 percent in the first six months.
Other hospitals adopting his five-step program produced similar results, some seeing their infection rates fall to zero. Just as a pilot performs a pre-flight checklist before every flight, healthcare providers can be taught to perform this central line safety checklist.
The California Department of Public Health recently issued a statement about central line-associated bloodstream infections (CLABSI):3
“It is estimated that more than half of CLABSIs may be preventable if hospitals adhere to all of the recommended central line insertion practices (CLIP), which together are called a bundle, for each central line insertion.”
It goes on to say that infection rates are strongly controlled by infection control practices, with low rates reflecting “greater diligence with infection prevention care practices.”
It’s clear from all of this data that central line infections are far more preventable than many hospitals want to admit, indicating the solution requires not only a procedural adjustment but an industry-wide attitude adjustment as well.
Failure to perform any of the five steps illustrated below can result in a fatal infection that will kill you. This is very serious. Remember TWICE as many people die every year from this as die from car accidents in the US.
Image source: Vox
How Prevalent Are Hospital-Acquired Infections?
It’s unlikely that 100 percent of all hospital-acquired infections (HAIs) could be prevented with meticulous care, but they certainly could do a FAR better job at reducing patients’ risk. According to the most recent report by US Centers for Disease Control and Prevention (CDC),4 one in 25 patients now ends up with a hospital-acquired infection.
In 2011, an estimated 722,000 patients contracted an infection during a stay in an acute care hospital in the US, and about 75,000 of them died as a result.5 That amounts to more than 205 deaths daily! More than half of all HAIs are contracted outside of the intensive care unit. The most common types include:
- Central line-associated bloodstream infections
- Catheter-associated urinary tract infections
- Surgical site infections after surgery
- Clostridium difficile infections
The most common organisms infecting central lines are coagulase-negative staphylococci (especially Staphylococcus epidermidis), Staphylococcus aureus, Enterococcus spp., Escherichia coli, Klebsiella spp., other enteric Gram-negative bacteria, and Candida spp.6,7
Infections are just one of the risks you face with standard medical care. The broader category of “preventable medical mistakes” represents the third-leading cause of death in the US, right after heart disease and cancer. According to the latest estimates, between 210,000 and 440,000 Americans die from preventable hospital errors every year. The federal government has decided to “solve the problem” of medical errors by quietly burying the data.
If You Acquire an Infection in the Hospital, Antibiotics Might Not Save You
Believing an antibiotic will cure your infection has been taken for granted in recent decades, but that’s rapidly changing. Experts warn that the age of antibiotic drugs is coming to an end, as more and more strains of bacteria are becoming resistant to even our strongest antibiotics. Two million Americans become infected with antibiotic-resistant bacteria each year, and at least 23,000 of them die as a result.
Antibiotic overuse and inappropriate use bears a heavy responsibility for creating this crisis, but the largest source of antibiotic exposure is actually from your food. Agriculture accounts for about 80 percent of all antibiotics used in the US. Tens of millions of pounds of antibiotics are administered to American livestock each year for purposes other than treating disease, such as making the animals grow bigger faster.
Antibiotic residues in meat and dairy, as well as resistant bacteria, are then passed on to you in the foods you consume. As just one example, more than 80 different antibiotics are allowed in cows’ milk. The CDC8 concluded that as much as 22 percent of antibiotic-resistant illness in humans is in fact linked to food. In 2013, CDC declared that antibiotics used in livestock play a significant role in antibiotic resistance and “should be phased out.”
Nightmare Bacteria Are a Wake-Up Call
According to the Infectious Disease Society of America (IDSA), just one organism — methicillin-resistant Staphylococcus aureus, better known as MRSA — kills more Americans each year than the combined total of emphysema, HIV/AIDS, Parkinson's disease, and homicide.9 The real death toll could be much higher because no one is tracking the full extent of antibiotic-resistant infections in the US.
Unfortunately, hospital settings are among the most dangerous of places when it comes to contracting infections, and many of these are now drug-resistant, which is why lethality is growing. For example, nightmare bacteria called CRE (carbapenem-resistant Enterobacteriaceae) are nearly impossible to kill because they’re resistant to virtually every antibiotic in existence.
CRE appear to be on the rise in medical facilities across America. It’s estimated CRE increased five-fold in community hospitals across the southeastern US between 2008 and 2012 — an estimate that researchers admit is probably low.10
The most common form of CRE is a superbug form of Klebsiella, normally a harmless bacterium found in your intestinal tract. Children, elderly, sick, and immunocompromised individuals have the highest risk of infection. If it makes it into your blood (which is easy to do from a central line catheter), your odds of surviving an infection are a dismal 50 percent. Not only is Klebsiella resistant to nearly all antibiotic drugs, but it can transfer its antibiotic resistance gene to other bacteria, which is why experts are so concerned.
Safeguarding Your Care While Hospitalized
Once you’re hospitalized, you’re immediately at risk for a number of potentially harmful situations, so one of the best safeguards is to have someone there with you serving as your advocate. Dr. Andrew Saul has written an entire book on the issue of safeguarding your health while hospitalized. Frequently, you’re going to be relatively debilitated, especially post-op when you’re under the influence of anesthesia — you won’t always be able to maintain your usual clear-headedness. Having a personal advocate is particularly important for elderly and pediatric patients.
It’s important to have someone present to ask questions and take notes. For every medication and procedure given in the hospital, questions should be asked such as: “What is this medication? What’s the purpose of this procedure?” It’s also not a bad idea to ask, “Have you washed your hands?” Most people, doctors and nurses included, are more apt to go through that extra step of due diligence to make sure they’re getting it right if they know they’ll be questioned about it.
If someone you know is scheduled for surgery, you can print out the WHO surgical safety checklist and implementation manual, which is part of the campaign “Safe Surgery Saves Lives.” The checklist can be downloaded free of charge here. If a loved one is in the hospital, print it out and bring it with you, as this can help you protect your loved one from preventable errors in care.
Optimizing Your Microbiome Is One of the Best Strategies for Preventing Dangerous Infections
A major factor in your susceptibility to infections is the strength of your immune system and the health of your microbiome. While antibiotic abuse and overuse has fueled deadly infections, natural probiotics can help protect you. Reseeding your gut with beneficial bacteria is key for preventing pathogenic microbes from wreaking havoc with your health. To optimize your microbiome, keep the following recommendations in mind:
- Eat plenty of fermented foods. Traditionally fermented and cultured foods are extremely beneficial for your digestive health and immune system. Good options include lassi, fermented grass-fed organic milk such as kefir and yogurt, and natto (fermented soy). Fermented vegetables are another excellent way to supply beneficial bacteria to your gut and may also be an excellent source of vitamin K2, if made with a specially formulated culture.
- Take a probiotic supplement. Although I'm not a proponent of taking a large number of supplements (the majority of your nutrients should come from your food), probiotics are an exception if you don’t eat fermented foods on a regular basis.
In addition to knowing what to add to your diet, it’s equally important to know what to avoid:
Antibiotics, unless absolutely necessary; when you do use them, make sure to reseed your gut with fermented foods and/or a probiotic supplement Conventionally-raised meats and other animal products, as CAFO animals are routinely fed low-dose antibiotics, plus genetically engineered grains, which have also been implicated in the destruction of beneficial gut flora Processed foods, excessive sugars, and emulsifiers (polysorbate 80, lecithin, carrageenan, polyglycerols, xanthan gum, and GMOs) typically heavily contaminated with pesticides such as glyphosate, aka Roundup) Chlorinated and/or fluoridated water Antibacterial soap Agricultural chemicals such as glyphosate