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medpundit |
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Tuesday, July 23, 2002The Tribune linked the deaths of 2,610 infants in 2000 to preventable hospital-acquired infections. Examining patients of all ages, the Tribune identified 75,000 preventable deaths where hospital-acquired infections played a major role. This analysis, based on the most recent national data, is the most comprehensive of its kind and draws on thousands of hospital and government inspection reports. Pediatric intensive care units experience up to three times the number of infections as other hospital areas, including operating rooms, according to the Tribune analysis and records at the federal Centers for Disease Control and Prevention. And though overall infant mortality rates continue to decline inside U.S. hospitals, the rate of lethal pediatric infections acquired in hospitals is rising, state and federal health-care records show. They then proceed to detail several cases of infection, all of which happen in neonatal intensive care units. Every case involves premature infants, no cases involve older children or healthy newborns. Premature infants are particulary vulnerable to infection, which the article does point out. Their immune systems are underdeveloped, their skin is thin and easily penetrated by bacteria, and they are born with problems that require invasive procedures such as catheters and respirators to keep them alive. With such poor immune systems, it is harder for antibiotics to do their job. They require the assistance of the body to be most effective. In addition, once such a vulnerable and small patient aquires an infection, things go bad fast. A baby who seems to be doing fine one minute, can be dead from sepsis within a few hours. All of this makes the fight against hospital aquired infections particularly difficult. It is also true that they are kept in the same room as other premature babies rather than in separate rooms as in adult intensive care units, but unlike adult intensive care, the preemie nurses are at the bedsides of their patients at every moment, watching for clues that something may be going wrong. As a group, they are the most diligent of nurses. It is not at all clear that putting each preemie in their own room would improve their mortalitiy. Many of the cases highlighted by the article are infections caused by Pseudomonas aeruginosa, a bacteria so ubiquitous that it has even been found in distilled water. Certainly, basic hand washing is a must when dealing with such vulnerable patients, but pseudomonas is very difficult to eliminate entirely. No matter how careful a hospital staff is, there will always be some risk of patients aquiring it, especially premature infants. Maybe the Tribune series will do some good by getting hospitals to re-examine their infectious control techniques and by reminding doctors and nurses of the importance of basic hand washing, but it unfortunately leaves the overwhelming impression that hospitals are a more dangerous environment than they actually are. posted by Sydney on 7/23/2002 07:41:00 AM 0 comments 0 Comments: |
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