Medical centers trying to reduce risk of hospital-acquired infections

Each year millions of patients check into hospitals for treatment and instead get a completely different medical condition than they came in with ““ a hospital-acquired infection.

Obtaining an infection while hospitalized is one of the top 10 causes of death in the country, said Zachary Rubin, epidemiologist at Santa Monica-UCLA Medical Center and Orthopaedic Hospital.

“We sometimes don’t think of infectious diseases because we can’t see them,” said Dr. Dawn Terashita, a medical epidemiologist at the Los Angeles County Department of Public Health.

The Ronald Reagan UCLA Medical Center reported higher rates of certain hospital-acquired infections ““ like one diarrhea-causing agent ““ compared to other medical centers between April 2010 and March 2011, according to a report released by the California Department of Public Health.

“(Treatment of hospital-acquired infections) is really an important and typical challenge right now for hospitals throughout the country,” said Gerald Kominski, director of the UCLA Center for Health Policy Research and a professor of health policy and management.

The Centers for Disease Control and Prevention standardized the protocol for reporting hospital-acquired infections in 2009. Since then Los Angeles County has reported as many of these infections as the rest of the state during the time period, according to a Los Angeles County Department of Public Health report released last year.

One possible reason for the similarities may be that Los Angeles represents the largest portion of the California population, so the rates reflect one another, Terashita said.

UCLA has made efforts in the past to combat the threat of hospital-acquired infections.

Among the university’s most recent efforts is a program to remove bacteria in patients’ noses and a recently funded clinical trial, in which copper surfaces will be used in the UCLA Medical Center to study the effects of the metal on bacterial growth.

“As physicians, part of our role is to make sure people are healed as a result of our actions and not harmed,” Rubin said.

With a widely recognized liver transplant program, the medical center at UCLA treats many patients who are given medication to help their bodies accept a new organ, said Daniel Uslan, director of the antimicrobial stewardship program at the David Geffen School of Medicine. But the medication does so by lowering patients’ immune system responses, which makes them more susceptible to hospital-acquired infections, Uslan added.

Rubin, who specializes in infectious diseases, treats patients with hospital-acquired infections, including an elderly man whose new but infected prosthetic knee cost him his active lifestyle and added the cost of two extra surgeries to his hospital bills, he said.

Rubin said he remembers a woman who entered a hospital for a hip replacement, but left with an infection that resulted in a blood clot that ultimately ended her life.

Infections pose a challenge for two reasons especially, Uslan said.

First, modern hospitalized patients in the United States are sicker than they have been in the past and are more prone to getting infections, he said.

He added this trend may exist because doctors are doing a better job at treating healthier patients outside of the hospital, and advanced treatments like organ transplants mean hospitalized patients are more vulnerable to infections than before.

In addition, bacteria spread in hospitals seems more resistant to antibiotics than the bacteria found outside, he said.

The large and varied patient population at the medical center must be taken into consideration when comparing statistics about hospital-acquired infections between hospitals, Uslan said.

“We see the sickest of the sick here,” Rubin said.

In an effort to prevent hospital-acquired infections at the patient-specific level, the medical center hires specially trained nurses called infection preventionists, Uslan said.

UCLA researchers were also awarded a $2.5 million grant last month for a clinical study at the Ronald Reagan UCLA Medical Center aimed at further eliminating hospital acquired infections, which 2 million people a year suffer from.

By changing some surfaces in two intensive care units to copper, a material known to kill bacteria on contact and already used in the cooking industry, researchers plan to compare the health benefits and financial costs of copper to those of stainless steel and plastic, which are currently used in the hospital, Uslan said.

Part of a doctor’s role is to ensure patients are healed rather than harmed by his actions, Rubin said. So at the UCLA medical center, where the patient population is large and diverse, studying hospital-acquired infections is a significant endeavor, he added.