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Drug-resistant bacteria
March 5th, 2014
11:02 AM ET

CDC: Hospitals contributing to rise of superbugs

Health officials have long been warning us about the overuse of antibiotics and the rise of drug-resistant "superbugs." Now the Centers for Disease Control and Prevention is shining a light on how hospitals are contributing to the problem.

"Prescribing (antibiotics) varies widely among hospitals," CDC Director Dr. Thomas Frieden, an infectious disease expert, said in a press conference Tuesday. "Practices that are not optimal are putting patients at unnecessary risk of future drug-resistant infections, allergic reactions and intestinal infections that can be deadly."

About half of hospitalized patients receive antibiotics during their stay. But there is a significant difference in the rate of antibiotic prescription, with some hospitals prescribing up to three times as many antibiotics as others, according to a new report published Tuesday in the CDC publication Vital Signs.

Clostridium difficile – also known as “C. diff" – is a bacteria that causes diarrhea, and mostly causes infections in patients taking antibiotics. "Reducing the use of high-risk antibiotics by 30% can lower deadly diarrhea infections by 26%," the report noted.

Frieden said the overuse and misuse of antibiotics is contributing to an increase in drug-resistant bacteria, which render antibiotics useless.  He remembers treating patients who had "run out" of antibiotics they could take.

"We have to protect patients by protecting antibiotics," he said.

In an effort to protect antibiotics, the CDC released suggestions for hospitals and state and local health departments to improve prescribing practices.

Specifically, the CDC's plan is made up of two broad strategies. Hospitals are being asked to implement a seven-step checklist that includes tracking current prescription practices, reporting patterns of drug-resistant bacteria and educating staff about more effective use of antibiotics.

State and local health departments are being asked to work with hospitals to track rates of drug-resistant bacteria and implement forms that would transfer with patients between facilities, listing information about drug-resistant bacteria the patients may be carrying.

The CDC also suggests physicians order tests before beginning to treat a patient, then start treatment promptly, keeping careful notes about the course of treatment and checking on the patient's status two days later to ensure the antibiotics are working properly.

For doctors, there's a tension between thinking of the greater good of society and the immediate needs of the patient, says Dr. Scott Flanders, a professor of medicine at the University of Michigan, who was not involved with the report.

Often, patients come in to hospitals with symptoms that could be indicative of a bacterial infection, and doctors will begin antibiotics immediately, Flanders said, erring on the side of treatment.

In conjunction with the CDC's suggestions for hospitals and health departments, the federal government is expanding the National Healthcare Safety Network, which helps track infections.

The CDC's report was released in collaboration with the American Hospital Administration. Dr. John Combes, senior vice president of the AHA, said decreasing the rate of infections caught in hospitals is an important part of decreasing antibiotic prescription rates in hospitals overall.

The AHA will release a list of resources for hospitals to help improve antibiotic-prescription practices in the next year. Reducing rates of antibiotic-resistant bacteria and C. difficile will take some work, Combes said.

"Preventing infections is a never-ending process within the organization, and new challenges and situations are emerging daily," said Combes. "But we recognize that more can be done and will be done."


soundoff (41 Responses)
  1. tjp44

    yes, the Hospital is the only place you can contract HA-MRSA, the worst infection, and they succeeded in infecting me.....

    March 5, 2014 at 13:08 | Report abuse | Reply
    • Guest

      Not true. Mrsa is widespread in the community outside hospitals

      March 5, 2014 at 17:39 | Report abuse |
    • unreal

      Give Mānuka honey a try.
      Expensive but worth a try.

      March 5, 2014 at 19:56 | Report abuse |
    • steve

      Of course the hospital is the only place you can get HA-MRSA. HA stands for hospital acquired.

      And if you think that's the "worst" infection out there, you are only speaking from personal experience.

      March 5, 2014 at 21:13 | Report abuse |
    • Seydlitz

      Worst infection... Dream on. HA-MRSA is much more treatable than VRE, and KPC strains (and other ESBL strains).

      March 5, 2014 at 21:23 | Report abuse |
    • exhealthcareworker

      hospital workers intenionally infecting patients and health dept covering it up
      example MN Fairview ridges operating room- nurse wiping patient fecal matter and touching everthing in the surgery room with the poop gloves while the other nurse laughed and made false statements about the surgical technician telling them it was wrong during the case-surgical technician fired and state made life miserable including trying to murder .not the only incident either in this stateinfections and disease is job creations for hospitals and nurses let the gov track me down for more info

      March 5, 2014 at 22:06 | Report abuse |
    • Med

      VRE? Try CRE. Carbapenems used to be heavy hitters. Just wait, they will be bringing back colistin and chloramphenicol pretty soon.

      March 6, 2014 at 00:51 | Report abuse |
    • Nathan

      Of course the hospital is the only place you can get HA-MRSA, otherwise you would just have MRSA, you stupid twit. What you do think the HA stands for?

      March 6, 2014 at 13:36 | Report abuse |
    • Helen McMichen Parker

      My husband contracted MRSA. When he had bladder cancer surgery in Jun 2006, he did not have it. When he went back in July 2006 for another bladder surgery it had to be postponed because he had MRSA. I believe he got it in Jun with the original surgery. I looked it up on liine. There is an H which is contacted in the hospital and a C which is community related. However, that article said the majority of MRSA is H-contracted. A friend disputed this and I just dropped it because she works at the hospital in communicable disease. I figured that was a discussion I would not win.

      March 6, 2014 at 21:10 | Report abuse |
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      March 12, 2014 at 11:08 | Report abuse |
  2. tjp44

    then they act like it is your fault..........malpractice time!

    March 5, 2014 at 13:11 | Report abuse | Reply
  3. unreal

    Mānuka honey.

    March 5, 2014 at 19:58 | Report abuse | Reply
  4. SaneGOP

    And the hospitals can blame the litigate nature of their base and the system that forces them to err on the side of caution with anti-biotics.

    March 5, 2014 at 20:23 | Report abuse | Reply
  5. EvinAR

    We will never win over microbes. The rate at which that they reproduce and vary themselves is such that there will ALWAYS be a resistant strain, and those will proliferate over the non-resistant ones. We were fooling ourselves for a few decades; that's all we can ever do against Earth's oldest organisms.

    March 5, 2014 at 20:49 | Report abuse | Reply
  6. Oliver

    #12 looks like my testicles when I wake up in the morning

    March 5, 2014 at 22:13 | Report abuse | Reply
    • micro-tech

      #12 should be the last thing that you would want to associate with your testicles since it is gonorrhoeae. You know what that is don't you?

      March 5, 2014 at 22:43 | Report abuse |
    • jason

      bed head ball sac style...ive got the same problem but i just use a little mousse for that salon look.

      March 6, 2014 at 20:30 | Report abuse |
  7. Joe

    Most people with foley catheters get bladder infections, would you prefer they go untreated and turn into bad and dangerous kidney infections?

    March 5, 2014 at 22:14 | Report abuse | Reply
  8. WhiteCoat

    So one federal agency – the Centers for Disease Control – says that we have to protect patients by *withholding* antibiotics.

    Yet on its "Hospital Compare" web site, another federal agency – the Centers for Medicare and Medicaid Services – grades hospitals on how quickly they *provide* antibiotics for things like surgical procedures and for a chest x-ray showing any possibility of pneumonia. Despite the fact that most pneumonias are viral and will not respond to antibiotics, if hospitals DON'T give antibiotics – even if pneumonia is questionable – then CMS considers the hospitals as being "below average" and the hospitals are penalized.

    On one hand, the policies of federal agencies contribute largely to the problem of antibiotic resistance and on the other hand the federal agencies blame the hospitals for the problem.

    What a great way to create and reinforce a negative public impression about hospitals and medical care.

    Wonder how Dr. Thomas Frieden would respond to this issue.

    March 5, 2014 at 22:51 | Report abuse | Reply
  9. Josh

    All the people on here complaining about how Hospitals are evil, don't solve anything, so on and so on are more than welcome to refuse treatment and die from Pneumonia and many other treatable illnesses like people did in the "good old days" when, you know, birth rates were microscopic and life expectancy was half of what it is now... Would make Healthcare a lot cheaper for the rest of us who enjoy being healthy and taking advantage of modern medicine.

    Seriously... People baffle me sometimes. Same with the Anti-Vaccination Crew.

    March 6, 2014 at 00:54 | Report abuse | Reply
  10. radar657

    What we really need to be worried about when admitted to hospitals are blood-borne infections. Make sure your gloved nurse is swabbing that IV port with an alcohol prep for a full 2 mins before they inject it.

    March 6, 2014 at 01:52 | Report abuse | Reply
    • dan

      or Betadine too. That works just as well.

      March 6, 2014 at 12:09 | Report abuse |
  11. mary

    I dought there will never be total eradication of these kinds of things.. WE find a way to cure one and another one comes along..One way or another we will always be dealing with some bacteria or virus that can kill us..
    The further we get ahead the faster we stay in place.
    Scary stuff..

    March 6, 2014 at 03:52 | Report abuse | Reply
  12. Willow

    What we need to be concerned about is all of the anitbiotics in our food supply. The chickens and cows that make up the majority of our food are pumped up with anitbiotics. As consumers those antiobiotics get passed on to us. I do agree though that some doctor's do over prescribe antibtiotics at times. However, the doctor's are not the major cause of humans becoming drup resistant to certain bacterias.

    March 6, 2014 at 09:01 | Report abuse | Reply
  13. Timmy Suckle

    I kissed my way up to CEO at a health insurance company. Now I take over $1,000,000 of your health care dollars for NO VALUE ADDED to your health care. And that’s just me. Now think about how many other CEOs, VPs, Directors, Managers, etc. are at my company alone. Now multiply that by thousands of others at hundreds of other health insurance companies. From 10 to 25% of your health care dollars go towards administration that adds NO VALUE to your health care. But my company’s PAC dollars will continue to fool you little people into thinking that a single payer system will be bad. Little people like you are so easy to fool. Little people also don’t realize that a single payer system is the ONLY system that would allow little people (as an entire country) to negotiate better health care prices. Little people don’t realize that the Medical Cartels already know that. And that is the reason why the Medical Cartels spend so much PAC money from the hospitals and doctors lobbying against a single payer system. Some little people say that a single payer system would cost you little people more. But if that were true, then wouldn’t the hospitals and doctors WANT that extra money? Yes they would. So why do the Medical Cartels lobby against a single payer system? It’s because the Medical Cartels know it would allow little people to negotiate better health care prices. And that’s what the Medical Cartels are afraid of. Period.
    But us big wigs at insurance companies, hospitals, and pharmacy companies don’t ever need to worry about health care no matter what it costs. We get our health care paid for one way or another by you little people. And we get the little people that work at our companies to contribute to our PACs. And us big wigs say it’s to protect the little peoples’ jobs. But in reality it would be in the little peoples’ best interest to NOT contribute to the PAC. Again, little people are so easily fooled. I won’t ever have to worry about losing my job with so many little people being brain washed by the Medical Cartels’ PAC money. Not only that, the Medical Cartels’ PAC money is used to elect so many republicans that will never allow a single payer system. Republicans have always fought against any meaningful health care reform. But that’s what our Medical Cartels’ PACs pay them for. Politicians can be bought so easily.
    Pretty soon the only people that will be able to afford health care is us big wigs. And that’s the way it should be. We don’t want you little people using up the resources when we need them. And once again, I thank you little people for capping my SS tax at the $117,000 level. Now I only pay 1.17% SS tax and you little people pay 6.2%. Also, thank you for extending my tax breaks. I’m using the extra money on my vacation houses.

    March 6, 2014 at 09:38 | Report abuse | Reply
    • Julie

      You are the lowest form of life. Congratulations.

      March 7, 2014 at 06:30 | Report abuse |
  14. John vance

    There is no doubt that antibiotics are overused, but reducing usage is hard to achieve. Every doctor has one or more anecdotal horror story of delayed treatment.
    In my area of neonatology, missing early evidence of infection is both easy to do and very unforgiving. A few hours delay can make a lethal difference when dealing with patients whose immune capacity is reduced or inherently limited.
    The result is many patients ending up on antibiotics as default position.

    March 6, 2014 at 10:15 | Report abuse | Reply
  15. Just Sayen

    It always amazes me to read articles on "Super Bugs" and nowhere ever do they talk about MRSA!! VR MRSA (Vanco Resistant MRSA) is FAR more lethal than HA – MRSA. It is up there with CDIF but many people are not educated enough to know how MRSA is TURLY being passed (IE: LIVES ON METAL FOR UP TO A WEEK – wipe your grocery cart the next time you shop!)

    Just Sayen

    March 6, 2014 at 10:29 | Report abuse | Reply
  16. John Sokalski

    When hospitals cut budgets one of the first places they hit is housekeeping. Housekeeping is primary to keeping a grip on the spread of infectious diseases in hospitals. My brother was recently in a hospital and before he was checked out of his room, a cleaner came in to "clean" the room for the next patient. My brother who is a doctor freaked when the employee took out a broom placed a dry rag on it an began to dust the walls down. My bother asked why he wasn't using a disinfectant or even a water damp cloth at worse to do the job. The employee said that this is how they wanted it done. They had no disinfectant to mop the surfaces. OMG!!

    March 6, 2014 at 11:27 | Report abuse | Reply
  17. skeptical

    Pressure needs to be put on hospitals to reduce salaries of redundant upper and middle management, and focus resources where it matters. I've worked in hospitals, and housekeeping is usually contracted out, underpaid and poorly skilled. I'd argue it's a far more important job in a hospital than half of what management does.

    March 6, 2014 at 11:42 | Report abuse | Reply
  18. truthtruth

    gosh...the problem with the spread is also due to hospital workers, especially nurses and medical assistants, wearing scrubs and shoes outside of the hospital. a few hospitals imposed rules requiring all staff to change when they come to and prior to leaving work. this decreases the spread to the community.

    March 6, 2014 at 13:01 | Report abuse | Reply
    • Nathan

      Please cite specific studies to accompany your information.

      March 7, 2014 at 13:57 | Report abuse |
  19. JDMArkansas

    One thing that should be done IMMEDIATELY is to ban the non-therapeutic use of antibiotics in animal feed. Antibiotics should NEVER be given to an agricultural animal except with a veterinarian's prescription for TREATMENT OF A SPECIFIC BACTERIAL INFECTION, just as it should be with a human patient. Adding antibiotics to standard animal feed should be illegal.

    In case of emergency where treatment needs to be started quickly, a culture should be taken before administration of the antibiotic, the antibiotic could be temporarily administered, but then the culture should be tested for susceptibility to the antibiotic after it is grown. (Cultures typically take days to grow and test.) However, if the culture is NOT susceptible to the antibiotic, the antibiotic should be discontinued immediately. This should be done for BOTH human and non-human patients.

    March 6, 2014 at 16:55 | Report abuse | Reply
  20. DrInTheMiddle

    I give up. Really, I do. The public expects a 0% miss rate on diseases that do not usually have black and white tests available, or bacterial cultures that do not result for a day or two. If we doctors opt for conservative treatment, and something is "missed," the public is quick to sue. We are punished by CMS if we do not start antibiotics quickly enough, and now are the topic of this "overprescribing" topic. It is truly a no win for us physicians, you- the patient, or our community. But you better believe that every time I am going to choose the option that provides me the lowest risk for being sued by you, and not lose the house that my children have grown up in. For my family member, I would want to wait if the diagnosis was not clear, rather than take the risk of c. Diff. Colitis. In fact, I did wait for 2 days for the results of urine cultures when my two year old son had a questionable urinary tract infection (truly a questionable urinalysis, I saw the result myself). Turned out to be negative, but I sure as heck would not have sued a doctor if the cultures were positive. My message to the public: you just cannot, cannot have it both ways.

    March 6, 2014 at 18:16 | Report abuse | Reply
  21. A

    There are numerous studies showing that early administration of antibiotics is critical and life saving in people with significant bacterial infections. The guidelines state that antibiotics should be started if a patient is unwell and an infection is suspected, because waiting for definitive proof kills people.

    March 6, 2014 at 21:20 | Report abuse | Reply
  22. carol

    Manuka honey, Essential oils (antimicrobial, Colloidal Silver, Intravenous Vitamin C for MRSA, and Akja Genisis. Natural approaches are rarely considered.

    March 6, 2014 at 21:44 | Report abuse | Reply
  23. Julie

    Before antibiotics were invented, people used COLLIDAL SILVER to treat infections. A few drops into a glass of water is all you need. (I use Nutri Silver). There is no risk of MRSA or other bug-resistant infections from using it.

    March 7, 2014 at 06:26 | Report abuse | Reply
  24. Diane

    My husband caught c.diff twice in the hospital after surgery. This is a terrible intestinal infection. He is being treated now for it and he has lost so much weight. Something has to be done about this bad infection.

    March 7, 2014 at 08:14 | Report abuse | Reply
  25. Marputo

    Check out Dr. Quave's job!
    She is working on MRSA in a different way!
    Instead to target the bacteria itself, she try to weaken their ability to protect them selfs!

    March 7, 2014 at 10:11 | Report abuse | Reply
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