Horror in the Hospital (& Disclosure Laws)

For anyone not thoroughly worried by Maryn McKenna's book Superbug: The Fatal Menace of MRSA, there's a Klebsiella story in the Wall Street Journal that will scare even the most fearless hospital-goer:

An outbreak of antibiotic-resistant bacteria raced through a top research hospital at the National Institutes of Health last summer, killing six patients and possibly contributing to the deaths of five others, researchers reported today. . . . The outbreak began in June of 2011, when a 43-year-old female patient with a history of multiple drug-resistant infections was transferred from a New York City hospital.

Although the patient was admitted into an isolation area, a Klebsiella pneumonia infection she had brought with her into the hospital soon leapt to at least three other patients. The NIH did not identify the New York hospital. The outbreak was brought under control by the end of the year. . . . [The story] underscores how health-care facilities are responsible for outbreaks, a broad problem that experts say leaves as many as 100,000 Americans dead each year. . . .

Hospitals have resisted efforts to require mandatory reporting of infection rates, in part because of the longstanding difficulties of establishing whether patients arrive with infections. An article in the Journal for Healthcare Quality earlier this year said 21 states have adopted public reporting requirements for hospital infections. 

One of my students wrote an excellent paper calling for "universal screening for MRSA ... to be done for all hospital admissions in order to treat MRSA in hospitals and decrease the rate of MRSA within the community."  Other steps are also necessary in relation to microbial infections.  One wonders what it will take so see far more serious and coordinated responses to the threat.  Kevin Outterson has written several excellent articles on growing antibiotic resistance, noting that antibiotics are uniquely susceptible to losing power due to overuse--but even a legal category for antibiotics as a whole could be overbroad, because of the unique properties of each microbe.   I hope that scholarship like his helps inform a broader public policy response to this latent crisis.

[FP]