A look at hospital infections after young Bangor mother’s death

By Jackie Farwell, BDN Staff
Posted Aug. 15, 2013, at 6:14 p.m.

Kathy Day of Bangor read about the vicious infection that claimed the life of young mother Heather Nichols with a mix of heartbreak and recognition.

Day, a former nurse, has worked to raise awareness about debilitating and deadly infections after a similar “superbug” sickened her elderly father following a hospitalization in 2008.

It remains unclear where Nichols picked up the bacteria that her husband said rapidly developed into a rare infection and ravaged her body. The often harmless bacteria may have been living on her skin, invading her tissue during the birth of her daughter. She may have contracted it somewhere in the community.

Or, she may have gotten the infection at the hospital where she gave birth, Eastern Maine Medical Center. Infections are one of the most common forms of patient harm and have become a major focus at hospitals, nursing homes, rehabilitation centers and other health care settings.

Nationally, the U.S. Centers for Disease Control and Prevention estimates that nearly 1.7 million hospital-acquired infections occur annually, contributing to approximately 99,000 deaths each year. They strike patients who are already weak from illness or injury, sometimes with devastating results.

As hospitals work to tackle the problem, the goal should be no infections at all, Day said.

“Every single one of those people counts,” she said, “and the perfect example is this young mother.”

EMMC has confirmed that Nichols is deceased, but offered no other comment on her case.

Infections can spread at hospitals through countless avenues. Bacteria may linger on surfaces, such as surgical instruments, bed linens, door handles and hospital staff’s clothing. Some germs spread through the air from a patient’s cough or sneeze.

Many hospital infections are familiar, such as pneumonia or a staph infection.

Others include “superbugs” that have grown resistant to antibiotics, such as a form of staph called methicillin-resistant staphylococcus aureus, or MRSA, and Clostridium difficile. Both bugs, partly fueled by overuse of antibiotics in the U.S. and worldwide, have wrought havoc on hospitals and nursing homes.

Other bacteria, called group A streptococcus, are otherwise tolerable germs commonly found in the throat and on the skin. Infections from group A strep are usually easily treated, but in some cases produce toxins that can destroy the tissue they infect.

“Patients ought to be aware that infections unfortunately can occur in hospitals and that hospitals are trying to put into place practices which will decrease that,” said Dr. Stephen Sears, state epidemiologist. “It’s always best to know more, because then they can be their own advocate.”

Patients most susceptible to infections include those in critical care, including individuals with catheters or using ventilators, said Donna Dunton, director of infection prevention at EMMC.

Hospital staff take numerous precautions to prevent infections, from wearing sterile caps, gowns and gloves to screening patients for dangerous organisms before heart procedures and administering antibiotics before surgery, she said. Propping up a patient’s hospital bed can help to prevent hospital-acquired pneumonia.

While infection control techniques and lab testing for dangerous germs have advanced significantly in recent decades, the bedrock of hospitals’ efforts to combat infection remains simple hand washing.

“No. 1 is hand hygiene,” Dunton said. “It’s the cornerstone of infection prevention in a hospital.”

Patients with underlying health problems, such as diabetes, are also at higher risk of infection, said Dr. James Raczek, EMMC’s chief medical officer.

“When people are sick, their immune system is affected by their illness, which can make them more susceptible to another infection, if they had one, or getting an infection if they’re sick from something else,” he said.

Patients can take steps to protect themselves. For planned procedures, ask about potential complications ahead of time, Day said. Research the hospital’s infection rates online or call up the infection control department and ask for them, she said. Consider requesting a screening for MRSA, a simple nasal swab test that shows whether the bacterium is present, Day said.

“I think it’s important if you’re in the hospital for anything that you have an advocate with you, a trusted loved one or friend who stays with you and someone that can stay 24 hours a day,” she said. “Oftentimes you’re medicated or drowsy or too sick even to watch for safety measures like hand washing, sterile techniques, dressing changes and so forth.”

Healthy habits, such as eating well and quitting smoking, also can boost the body’s immune system and help it fight off infection, she said.

While Day acknowledges that hospitals aren’t always responsible for infections that show up in their facilities, she bristles when she hears hospital administrators downplay their role in preventing potentially disabling and deadly infections.

In her father’s case, the hospital failed to inform them during his rehab for a minor ankle fracture that several other patients had already been sickened by MRSA, Day said. Her father died months after developing pneumonia from the organism.

“As long as [hospitals] can convince people that they couldn’t have done anything more, they couldn’t have done anything different, or it couldn’t have been prevented, basically what they’re saying is it’s part of doing business,” she said. “As long as they can get people to accept that, they can continue on and not really put their money where their mouth is with prevention and precautions. The public pressure is what’s going to make the difference.”

Raczek stressed that hospitals constantly strive to ensure that patients are safe.

“We do everything we can to try to prevent hospital-acquired infections,” he said. “We on a daily basis are doing things to try to make sure that when a patient comes into our hospital they are safe and don’t get an infection.”

Resources for researching hospital safety:

The Consumers Union Safe Patient Project

Consumer Reports’ hospital ratings

Medicare’s Hospital Compare website

GetBetterMaine.org, a Maine-based site for comparing doctors and hospitals

Leapfrog’s Hospital Safety Score

CORRECTION:

An earlier version of this story listed MRSA was a simple cheek swab test that shows whether the bacterium is present. It is a nasal swab.

http://bangordailynews.com/2013/08/15/health/a-look-at-hospital-infections-after-young-bangor-mothers-death/ printed on October 31, 2014