When Going to the Hospital Makes You Sick: Hospital-Acquired Infections in Louisiana

Hospital-acquired infections (HAI) kill at least 100,000 Americans each year. In fact, because the FDA may unintentionally underreport HAIs, the death toll may be greater than previously thought. HAIs are particularly virulent because many of them are resistant to antibiotics.

In Louisiana, local health officials have been recognized for their efforts in fighting HAIs. For example, Erica Washington, a 28-year-old epidemiologist who works in New Orleans, was honored at the White House last year for her efforts to improve hospital reporting of HAIs. Master of Science in Nursing (MSN) students with a population-health focus can examine the trends related to HAIs in Louisiana. They can also help hospitals to fight back against these deadly and often preventable diseases.

The Most Common Types of Hospital-Acquired Infections

Hospital-acquired infections are defined as bacterial, viral or fungal infections occurring 48 hours after an initial hospital admission. They fall into five main categories:

  1. Central line-associated bloodstream infections (CLABSI). These bloodstream infections happen when central line catheters carrying pathogens are inserted into blood vessels. They can lead to sepsis, which can be fatal.
  2. Catheter-associated urinary tract infections (CAUTI). CAUTIs usually happen when bacteria living on urinary catheters travel into the urinary tract, causing an infection.
  3. Ventilator-associated pneumonias (VAP). VAPs are lung infections, or pneumonia, caused by germs entering the lungs through ventilator tubing.
  4. Surgical site infections (SSI). Some SSIs involve only the skin around the surgical site, but others can invade subdermal tissues, organs or surgically implanted materials. Infections after coronary artery bypass grafting (CABG) surgery are especially dangerous.
  5. Other HAIs. Infections like MRSA, Clostridium difficile (C.diff.), Burkholderia cepacia (B. cepacia), Mycobacterium abscessus (M. abcessus) and hepatitis can also be transmitted through infected equipment, lack of sanitation or unsafe needle use.

HAIs in Louisiana

In Louisiana, incidences of CLABSIs as well as C. diff. infections are lower than the national average. However, infections caused by the methicillin-resistant Staphylococcus aureus (MRSA) bacteria are significantly more common in Louisiana hospitals than they are in other parts of the country. People that get MRSA typically start with another health condition that they receive antibiotics for in a hospital or nursing home setting. Then, they develop MRSA infections from antibiotic-resistant staph germs that live in bed linens, on bathroom fixtures, on bed rails or on medical equipment.

MRSA typically manifests as a skin infection or a boil. However, it can also invade the bloodstream or and the lungs. According to the CDC, the best ways for hospitals and nursing homes to prevent MRSA infections include:

  • Clean hands. Hospital or nursing home workers should frequently wash their hands with soap and water. Alternatively, they can use alcohol-based sanitizers both before and after caring for patients.
  • Clean facilities and equipment. Health care facilities should be kept as clean and as dry as possible. Additionally, all dressings and materials that come into contact with nasal discharge, blood, urine or pus should be carefully disposed of by nurses and doctors. Exam room surfaces should be cleaned with commercial disinfection or a 1-to-100 concentration of diluted bleach. Also, equipment that comes into regular contact with human skin, like blood pressure cuffs, should be repeatedly and thoroughly cleaned.
  • Contact precautions. People with MRSA should either have private rooms or only share a room with another MRSA patient. They should also avoid common areas like the hospital cafeteria or gift shop. Health care workers or visitors may be asked to wear gowns and gloves. Then, all gowns and gloves should be removed, and hands should be washed when leaving the MRSA patient’s room.
  • Wound care. A patient that goes home with surgical wounds or ports need to be taught how to take care of them before leaving the hospital.

According to the New Orleans-based Ochsner Clinic Foundation, HAIs cost the American health care system as much as $4.5 billion each year. Because many of these infections are preventable and no longer reimbursed by Medicare or other insurance, Louisiana’s health care facilities need to implement infection-control programs to keep patients safe. The average hospital infection-control program, according to Ochsner, costs about $100,000. Compared to the cost of infection and patient mortality, infection-control programs look like a smart investment.

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