As tens of thousands of Americans flood hospitals for treatment during the current flu epidemic, some also may end up sicker than when admitted, notably due to an infectious disease that’s a persistent and increasing worry for caregiving institutions: pneumonia.
The Wall Street Journal — citing federal statistics that pneumonia is the leading hospital acquired infection (HAI), sickening more than 150,000 patients annually in acute care hospitals — has highlighted new research showing that the disease is more common and problematic than now recognized.
Doctors and hospitals may have thought pneumonia struck mostly among elderly patients and those in intensive care units, particularly those needing ventilators and other machinery to assist their breathing. But the disease, “occurs across all units in all types and sizes of U.S. hospitals, putting every patient—the young included—at higher risk for developing the infection,” the researchers concluded after examining data on more than 1,300 patients at 21 hospitals.
More than half of the pneumonia cases the researchers studied afflicted patients younger than 65. They found that 71 percent of hospitals’ pneumonia cases were acquired outside the ICU, with 43 percent tied to medical-surgical departments. ICU infections accounted for 27 percent of cases, suggesting that, despite existing efforts, more must be done to reduce ventilator-acquired incidences of pneumonia.
Indeed, the Journal reported, that hospitals must do much more to help ensure their already sick patients aren’t made sicker — forcing them to stay longer and increasing the costs of medical care.
Challenged, too, by “super bugs” and other diseases, hospitals have campaigned to sanitize their facilities, using powerful disinfectants, including high-tech machines. They have cracked down on antibiotic prescribing (which has helped bring about drug-resistant superbugs), emphasized hand washing regimens, and even scrutinized how buggy doctors’ ties and patient-privacy curtains can be.
But nasty germs and viruses show great resilience still, with recent studies finding, for example, that they hang around in well-known hospitals — on door knobs, bed rails, and even in janitorial closets, where they dwell on dirty mops. Some teem in drains and traps in pipes under hospital sinks where they also biologically exchange resistance to drugs meant to kill them. (The infections get done in when they’re flushed into municipal systems and the water they thrive in gets heavily treated.)
To prevent pneumonia woes, experts recommend that hospitals rely on more intensive, front-line care. They have urged that nurses ensure that patients get properly positioned and elevated in bed to ease their breathing, for which they should receive special exercises, if appropriate. Patients also should be encouraged to get up and to walk around as soon as they can safely, so they get more air in their lungs and don’t let fluids build up and get trapped by lying around too much.
Some hospitals, the newspaper also reported, have improved their outcomes by getting patients to more regularly brush their teeth and gargle during their stays, especially before they undergo surgery requiring anesthesia. As a recent “Upshot” column in the New York Times reported, the mouth is a germy spot, and improving oral hygiene can be a key step to improving overall health — with tongues, gums, and teeth in good order adding to their owners’ social acceptance and not stigmatization for the reverse.
In my practice, I see the huge harms that patients suffer while seeking medical services, and the giant struggles they experience in accessing and affording quality medical care. I hope savvy seniors will protect themselves from pneumonia and some other diseases with vaccinations appropriate for adults. I also hope that anyone who hasn’t yet been felled by the flu heeds experts’ warnings and gets inoculated against the seasonal infection that already has killed 97 youngsters.
But that may not be the crucial issue here: Why are sick patients getting worse when hospitalized? I’m glad the Journal story is helping to spotlight the still too common, destructive, and lethal problems so many Americans suffer with hospital acquired infections. In 2011, the federal Centers for Disease Control and Prevention says, more than 700,000 Americans suffered HAIs and this led to 75,000 deaths.
These preventable sicknesses are part of the significant bane of medical errors, which claim the lives of roughly 685 Americans per day─ more people than die of respiratory disease, accidents, stroke and Alzheimer’s. Medical errors, experts say, may now be the third leading cause of death in the U.S., behind only heart disease and cancer. Doctors and hospitals have got a long way to go to ensure that patients leave medical facilities healthier than when admitted — well and alive.