Even healthy patients getting elective surgery can be stricken -- and die -- from a hospital-acquired infection, or HAI. The CDC has estimated that 2 million infections are acquired in hospitals each year, resulting in 90,000 deaths.

For too long hospital infections have been treated as a part of the "cost of doing business" in healthcare, but that explanation no longer holds water when several U.S. hospitals have succeeded at reducing one of the most serious HAIs, methicillin-resistant Staphylococcus aureus, or MRSA, to less than 1 percent.

Those hospitals include: University of Pittsburgh Medical Center, University of Texas M.D. Anderson Cancer Center in Houston, University of Virginia in Charlottesville and Brigham and Women's Hospital in Boston.

They have been able to demonstrate stunning declines in MRSA infections by a combination of good hygiene, identifying and isolating those with an infection, training and a change of hospital culture.

Meanwhile, MRSA has increased 32-fold, according to CDC's National Nosocomial Infections Surveillance system, which collected data from some 300 hospitals from 1980 and 2000. So in the "macro" sense, the problem is getting worse.

Both the CDC and the Joint Commission for the Accreditation of Healthcare Organizations say that controlling HAIs is a priority, and while everyone agrees the ever-increasing HAIs are too high, both also stress they do not have a regulatory function in controlling HAIs. That role -- such that it is -- falls to the states.

Pennsylvania has been the first state to officially collect data on HAIs, and each acute care hospital in Pennsylvania has to report the number of surgical, bloodstream, pneumonia and urinary-tract infections. In 2005 the state said 12,000 Pennsylvania patients acquired an infection in a hospital in the course of treatment, causing 1,500 deaths in 2004 -- and adding $2 billion to the cost of hospital treatment.

The Pennsylvania Health Care Cost Containment Council calculated that each Pennsylvania hospital patient who developed an infection cost $29,000, compared with $8,300 for those who did not.

Each infection costs $15,000 to $25,000, Dr. Loren Roth, senior vice president of quality care and chief medical officer of the University of Pittsburgh Medical Center, told UPI's Caregiving.

Dr. Issan Raad, chairman of the department of infectious diseases, infection control and employee health at M.D. Anderson, has developed catheters that are treated with antiseptic or antibiotics; they cost about $30 more than the regular catheters.

Several studies have found Raad's catheters effective in reducing infection and more cost effective.

"We are seeing an accelerated change -- independent efforts are being done in individual hospitals to reduce complications," Dr. Addison May, director of the trauma/surgical critical care residency at Vanderbilt University Medical Center in Nashville, told Caregiving.

"For example, catheter infections are theoretically the easiest to reduce -- and usually amazingly simple things can reduce them -- hand hygiene, draping the patient, having staff in sterile gowns, gloves and masks and using an antiseptic catheter cuts infection in half," he said.

"However, having hospitals adopt these methods is slower than you might think ... even though the hospitals often eat the extra cost caused by having the patients stay more days."

May pointed out that hospitals have to go beyond declaring policy changes to address infections: They must have a system to monitor compliance.

"A guideline for using caps, gowns and gloves for inserting a catheter had been in effect for five years, but before we put in a compliance tool or mechanism to either monitor or measure hospital compliance, it wasn't done that much," said May.

Alex Cukan is an award-winning journalist, but she always has considered caregiving her primary job. UPI welcomes comments and questions about this column. E-mail: [email protected]

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