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As hospital-acquired infections continue to kill patients in the U.S. it is the threat of lawsuits which may force steps to find and eradicate the organisms.

The biggest push for search and destroy may come, sadly, from the threat of lawsuits. Several large ones have been settled with hospitals where patients died of infections.

This is the way Slate reports the largely unchecked spread of methicillin-resistant staph, or MRSA.

Squash the Bug

Europe is killing off hospital infections. Why isn’t the United States following suit?

If you are an American admitted to a hospital in Amsterdam, Toronto, or Copenhagen these days, you’ll be considered a biohazard. Doctors and nurses will likely put you into quarantine while they determine whether you’re carrying methicillin-resistant Staphylococcus aureus, a deadly organism that is increasingly common stateside, especially in our hospitals. And if you test positive for methicillin-resistant staph, or MRSA, these European and Canadian hospital workers will don protective gloves, masks, and gowns each time they approach you, and then strip off the gear and scrub down vigorously when they leave your room. The process is known as “search and destroy”–a combat mission that hospitals abroad are undertaking to prevent the spread of germs that resist antibiotics. Our own health authorities, meanwhile, have been strangely reluctant to join the assault.

In the United States, MRSA kills an estimated 13,000 people every year, which means that a hospital patient is 10 times as likely to die of MRSA as an inmate is to be murdered in prison. The latest survey by the Centers for Disease Control and Prevention found that 64 percent of the Staphylococcus-aureus strains in American hospitals were MRSA–that is, resistant to the powerful antibiotic methicillin and other antibiotics–which makes them difficult to treat.

Given the dimensions of the threat, you’d think that the CDC would be making a priority of fighting it. After all, federal health agencies have spent billions to fight anthrax (which caused five deaths in 2001), smallpox (last U.S. death: 1949), and pandemic flu (yet to appear in the United States). And there is reason to think that search and destroy works, since health-care authorities abroad have kept rates of antibiotic-resistant bugs in their countries much lower than ours.

“Why are we spending millions if not billions on bird flu, a ghost that might not happen, when you have thousands being colonized by MRSA and dying of it?” asks Dr. William Jarvis, a top CDC hospital-infection expert until he resigned in 2003. At a March 29 hearing on hospital infections–which, all told, kill an estimated 90,000 patients each year–Rep. Bart Stupak, D-Mich., charged that the CDC had stood by, despite a steady rise in infections since the early 1970s.

The biggest push for search and destroy may come, sadly, from the threat of lawsuits. Several large ones have been settled with hospitals where patients died of infections. Fifteen states have passed laws that require hospitals to report infection rates, and another 28 are considering such legislation. An infectious-disease specialist I know offers a much simpler prescription: Whatever you do, he says, stay out of hospitals.

In Florida, as in the rest of the country, hospitalization for injuries or medical procedures carries a serious risk of a deadly infection. Unfortunately, my clients have little choice when their medical conditions require a hospital stay.

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