Clostridium difficile, (CDIFF), a highly contagious and potentially deadly “superbug” that plagues hospitals, nursing homes and other healthcare facilities in one of the superbug infections that continues to be highly unreported.
In most states, if not all, healthcare facilities must report a suspected outbreak of C. difficile or any other contagious superbug infections to the state Health Department within 24 hours. Most do not.
In one case in New Mexico, the CDiff infection went unreported, other caught the contagious infection, including fifteen infected, eight died, and amazingly the public was never informed.
Infection outbreaks in long term care facilities and the way they are handled expose what a Reuters investigation found to be dangerous flaws in U.S. efforts to control the spread of superbug infections. An examination of cases across the country reveals a system that protects the healthcare facilities where superbugs thrive, while leaving patients, their families and the broader public ignorant of potentially deadly threats.
Every year, hundreds of thousands of Americans are sickened and tens of thousands die from infections by antibiotic-resistant bacteria and C. difficile, a pathogen linked to long-term antibiotic use. Timely reporting of outbreaks of these infections is essential to stopping the spread of disease and saving lives, public health experts and patient advocates say.
Yet the United States lacks a unified nationwide system for reporting and tracking outbreaks. Instead, a patchwork of state laws and guidelines, inconsistently applied, tracks clusters of the deadly infections that the federal government 15 years ago labeled a grave threat to public health.
As a result, the United States has no way to count the deadly spikes in infections that hit the nation.
Most states require that hospitals, nursing homes and other healthcare facilities report suspected outbreaks of infectious disease, drug-resistant or otherwise, within one business day or less of identifying the problem so that health officials can intervene to halt their spread.
But while they require that outbreaks be reported, most states do not provide an explicit definition of the term. Instead, they leave it to the healthcare providers to determine when they are experiencing an increase in a particular infection beyond the usual number. That approach assumes that medical practitioners will know what’s normal in their facilities and gives them wide latitude in deciding when, or even whether, to report.
When a state does get involved, punishment is rare to nonexistent. At least 36 states are able to impose civil or criminal penalties, ranging from fines of up to $1,000 to jail time, for failure to properly report outbreaks. Yet not one of those 36 states cited an instance in the past five years when penalties were used.
The federal Centers for Medicare & Medicaid Services mandates that hospitals and long-term care facilities participating in the huge government insurance programs provide all necessary medical information when a patient is being transferred. However, the state outbreak reports Reuters reviewed showed that hospitals and nursing homes often do not alert each other when they transfer an infected patient, which can allow contagion to spread among multiple locations.
Long-term care facilities — nursing homes, rehab centers and the like — are particularly vulnerable to outbreaks. A Reuters analysis of death certificates found that from 2003 to 2014, annual superbug-related deaths at long-term care facilities increased 62 percent, from about 1,400 to almost 2,300.
Patients in these facilities are ideal superbug targets — the chronically ill, the very old, and anyone else with a compromised immune system. Collected under one roof, these people are easy prey.
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