U.S. Besieged by Superbug as CDC Fails in Its Core Mission

18 Mar, 2015 by Betsy McCaughey

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Just when you thought it couldn’t get worse at the Centers for Disease Control and Prevention after their deadly fumbling on Ebola and measles, new data show the agency vastly underestimated the threat of a superbug raging through our hospitals and nursing homes. Data from a leading medical journal show that 29,000 people in the U.S. are killed each year by Clostridium difficile, more than double what the CDC claimed just three years ago. Worse still, the CDC is dithering while deaths mount.

C. diff causes severe diarrhea, sometimes permanently destroying the lining of the colon and causing other deadly complications. The new data reveal that nearly half a million people get C. diff each year. It kills almost twice as many people as AIDS.

How do patients get it? Oral-fecal contamination, meaning traces of a patient’s diarrhea get into another patient’s mouth. Sorry, but that only happens because hospitals and other health care facilities are inadequately cleaned. The germ lurks on bed rails, curtains, faucet handles, doorknobs and call buttons, where it can survive for two years. Patients touch these invisibly contaminated surfaces and then touch their mouth or food and swallow the germ when they eat.

Just being assigned to a hospital room after a C. diff patient is risky. At one hospital, three patients treated consecutively in the same room all contracted C. diff. One died C. diff is also spread room to room on doctors’ and nurses’ hands. Alcohol-based hand sanitizers don’t kill it. Hands have to be cleaned with soap and water, but few health care workers do it.

Taking antibiotics increases your risk of getting C. diff by killing off good bacteria in your GI tract that might keep C. diff under control. But even patients who are not on antibiotics are getting it. The new data also show you can pick it up in a doctor’s or dentist’s office.

So how did the CDC so miscalculate the size of the C. diff problem in 2012? The agency counted C. diff on death certificates. But certificates often attribute death to whatever diagnosis the patient came in with, not the infection that actually caused death. The new data, based on laboratory records and published in the New England Journal of Medicine, reveal the enormity of the problem.

Rigorous cleaning is the answer. The Mayo Clinic reduced C. diff by 79 percent in a pilot project by doing one thing: wiping the frequently touched surfaces around patients’ beds once a day with a bleach wipe. The Jewish Hospital-Mercy Health in Cincinnati, Hunterdon Medical Center in New Jersey and other hospitals are duplicating that success. Bleach is used because the C. diff germ is encased in a shell that makes it harder to kill on surfaces than HIV, for example. Harder to kill on surfaces, but easier to deal with in every other way. It’s about cleaning, not drug addiction or unsafe sex.

Yet the CDC is not responding with the passion it brought to the AIDS epidemic in the 1980s. The agency says its aim is to reduce C. diff by 33 percent over five years. That’s too little too late.

The CDC has dragged its feet in addressing deadly contamination in hospital rooms. A survey of 1,100 rooms from Boston, New Haven, Stamford, New York City and Washington, D.C., revealed that cleaning staff overlook half of the surfaces, allowing germs to lurk and sicken one occupant after another.

Some hospitals, such as Johns Hopkins in Baltimore and the Huntsman Cancer Institute in Utah, are successfully deploying robotic cleaners — hydrogen peroxide room foggers, pulsating UV light machines and other technologies — to reduce bacteria in minutes, offsetting the fallibility of cleaning staff. Yet the CDC dawdles, saying year after year that a “better understanding” of these machines is needed. That gives hospitals an excuse to do too little.

In the meantime, the needless deaths continue. If you’re visiting someone in the hospital, bring a canister of bleach wipes and a pair of gloves. You could save a life.

Betsy McCaughey is the chairman of the Committee to Reduce Infection Deaths.

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