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There are trillions of bacteria living inside all of us. Why are we pretending they aren’t on our X-ray machines?
By Matt McCarthy
Dr. McCarthy specializes in infectious diseases.
Antibiotic-resistant superbugs are everywhere. If your hospital claims it doesn’t have them, it isn’t looking hard enough.
Hospitals are losing an important public relations battle over the expanding threat of superbugs, including the deadly fungus Candida auris. Though states are tasked with conducting outbreak investigations, they aren’t required to disclose their findings to the Centers for Disease Control and Prevention (and in many cases they haven’t). Grieving families are pushing for more transparency, while patient advocates smell a cover-up, likening the scenario to a restaurant failing to report an outbreak of food poisoning. In the midst of all this mistrust, hospital spokesmen are declining to comment. This is a mistake.
I hate to be the bearer of bad news, but these microbes are in our homes, cars and grocery stores. One study found that even after the use of disinfectant, more than half of hospital rooms still contain a superbug. Nurses and doctors carry these things around, too. Roughly 5 percent of health care workers are colonized with MRSA, a bacterium that kills thousands of people in the United States every year, and another study found that 10 percent of patients entering a hospital had a multidrug-resistant species on their hands. You don’t want to know what’s hiding on a handkerchief.
Here’s the thing: You almost certainly don’t need to worry about any of this. Potentially deadly bacteria and fungi live harmlessly on our hands, feet, and faces, and may never cause a problem. There are trillions of bacteria living inside all of us. Why are we pretending they aren’t on our gurneys, blood pressure cuffs and X-ray machines?
Demanding that hospitals release lists of every superbug they find within their walls, however, as many transparency advocates want, is not the answer. The irony is that the hospitals that see the most superbugs are often the best ones we have, for the simple reason that they have the most sophisticated diagnostic platforms, the most powerful antibiotics and the experts to administer them.
Compelling a world-class hospital like Massachusetts General Hospital, where I saw my first superbug as a medical student, to reveal a microbe list would only freak patients out. It wouldn’t explain where the microbes came from, whether any patients were infected, and how they were cured.
In a worst-case scenario, more transparency could lead to patients avoiding medical care out of a misplaced fear of encountering drug-resistant bacteria. Hospitals might start refusing patients with certain infections, especially those coming from nursing facilities where these microbes are common, out of a concern that the patient’s bacteria could be added to the list. This would do everyone a disservice: Patients wouldn’t receive optimal care and superbugs would multiply.
But hospital administrators and government officials do need to be honest about the microbes in our medical centers and explain what is really going on. No comment will no longer suffice. People have questions and this story is not going away. To ensure that patients are well-informed, hospitals should train spokesmen to address these issues and states should revisit their reluctance to disclose information. Above all, health care workers and administrators should speak openly about the measures their hospitals are already employing to keep people safe.
I’m not particularly interested in the microbes that dwell inside of a given hospital; what matters is whether its employees follow the strict protocols that prevent these organisms from going where they shouldn’t.
MRSA in a nostril is no big deal, but in the blood it can be deadly. The best hospitals follow best practices; they take proper precautions to protect patients and staff and require aggressive environmental cleaning and disinfection of patient care areas. They have antibiotic stewardship programs to ensure that drugs are used correctly and they have sophisticated strategies to identify and isolate anyone who develops a superbug infection.
Silence and evasion gives the perception that this is a problem spiraling out of control when, in fact, it’s not. An intricate tracking system exists so that epidemiologists across the country can monitor any outbreaks to ensure that proper protocols and containment strategies are implemented. We need to hear more from these superbug hunters.
We should heed the words of Nicholas Spoor, whose mother died earlier this year after becoming infected with Candida auris. “Secrecy is no way to treat an illness,” he told The Chicago Tribune. “You would think the way our nation dealt with the AIDS epidemic would have taught us that.” When it comes to superbugs, we should be careful not to replace the climate of secrecy with one of fear.
Matt McCarthy, an infectious-disease doctor at Weill Cornell, is the author of the forthcoming “Superbugs: The Race to Stop an Epidemic.”
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