The Silent Killer: Hospital-Acquired Infections

From the archives, comes this post about the health crisis no one cares about (except for the Mad Biologist. We are very caring): the 90,000 deaths per year from infections people get while in the hospital. And this number is probably an underestimate.

Bacterial infections aren't sexy: no one walks, bikes, hops, pogo sticks for the cure. There are no ribbons, no bumper stickers, and no hot celebrities (damn!). Yet, according to the CDC, bacterial infections acquired in hospitals kill at least 90,000 people per year in the U.S. Granted some of those who died would have died from something else anyway, but that's still a really large number. To put this figure in context, in 2004, roughly 18,000 people died from HIV. 40,000 died from breast cancer.

Today's Washington Post discusses the data from Pennsylvania:

12,000 Pennsylvanians contracted infections during a hospital stay in 2004, costing an extra $2 billion in care and at least 1,500 preventable deaths...

Here's the awful part: this number is probably a ridiculous underestimate. Health insurance claims indicate that the number of hospital-acquired infections in PA was around 115,000. It's probably not that high either: some infections may have been acquired outside of the hospital, and some hospitals may be gouging insurance companies.

However, the true number is probably pretty close to 115,000. First, the researchers removed many cases that might have been acquired before entering the hospital. Second, you charge insurance companies for $5 Tylenol and unneccessary consultations. You don't pump people full of amoxicillin just for the hell of it (Intelligent Designer, I hope not). So the 115,000 figure is probably pretty close.

So what kinds of infections are occurring in hospitals? The number one type of infection is urinary tract infections--all those wonderful catheters that poke through natural biological barriers that serve as the first line of defense against infection. (I'm not starting an anti-catheter movement here; you gotta pee. This, however, is just the way the biology works). The most lethal infections are respiratory infections (pneumonia) which kill 32% of patients who get these infections. These are usually associated with respirators.

Here's a pretty chart that breaks it down for ya:

Remember the quote from the top:

12,000 Pennsylvanians contracted infections during a hospital stay in 2004, costing an extra $2 billion in care and at least 1,500 preventable deaths...

Keep in mind that this could be off by a factor of ten. PA is 4% of the U.S. population, so now multiply everything by twenty-five. This kinda puts that whole shark attack thing in perspective, doesn't it?

I was going to end with the snarky comment above, but the more I think about this, the angrier I get. Look, the doings of Turd Blossom are important, no doubt about it. But this crisis--and 90,000 dead constitutes a crisis--is just as important. As the article notes, this isn't a new problem either. But it's not 'sexy.' It's a 'science/health' story, so it's not as important as the manly stuff. You have to know a little biology to understand the problem. You have to be numerically literate. And shock jocks and pundits don't bloviate about this because they're too ignorant of medicine and biology, so there's no hot air propelling this ship.

CDC estimates: 90,000 dead. 2,000,000 infected. Maybe if we called this an epidemic or a bacterial insurgency, people would pay attention.

Friends have often asked me why I don't take bioterrorism very seriously. I have a lot of reasons, but here's the germane one: the bioterrorist attack, for all intensive purposes, is already here. 90,000 dead per year--forget the World Trade Center, that's a Nagasaki sized number.

Meanwhile, antibiotic resistance is on the rise, so don't think the chance of dying from an infection is going to decrease. If anything it will increase. And don't think this doesn't affect you. At some point, many people will end up on respirators or catheters, and not just the very elderly. Twenty years from now, you don't want to ask the doctor what to do, only to have her say, "Morphine. Because the antibiotics won't beat the staph infection."

The Mad Biologist is very mad about this...