The spreading of infection is everybody’s business, but we need to take it more seriously. An earlier column discussed the spread of measles through a failure to vaccinate. But what about super bacteria? Why is their spread and that of many other germs of concern gaining momentum? Are there practical steps we should take on our own, and demand from health care providers, whether we visit a hospital or a doctor’s office? So let’s take a closer look at our remarkably germ-filled world, and how best to cope with it.
From a just completed and most compelling University of Michigan study, it was found, at two major hospitals in that state, that there were antibiotic-resistant superbugs in the nostrils and on the hands of 14 percent of patients, and one-third of objects used by patients, such as the nurse call button. This study also offered a cogent finding that may apply to many other hospitals: with all the places in hospitals that offer hand sinks and hand-sanitizer stations, with signs posted urging all to wash regularly, patients by and large don’t seem to notice or care.
Then there’s the sobering study presented last month at the European Congress of Clinical Macrobiology and Infectious Diseases, revealing that hospital staff, particularly those assigned to intensive care units, cannot be relied upon to wash their hands, either often enough or properly.
Enter yet another, new antibiotic-resistant fungus, Candida auras, that occurs right here in New York more frequently than anywhere else, with New Jersey as a strong second, according to the Centers for Disease Control and Prevention. This is set against a background where only 7.5 percent of hospitals in New York State received “A” ratings this year in a national survey of hospitals for patient safety, far below the 32 percent of “A” grades nationally.
Yet the medical professions, along with government health agencies, absolutely refuse to reveal exactly where C. auris has been found. What kind of public health policy is that? Is this policy of keeping things quiet connected with how little we hear of other risks from choosing not to vaccinate? Remember, for years, standard vaccinations prevent not only measles, but also smallpox, diphtheria, tuberculosis, etc. If a family makes the ill-informed choice not to vaccinate, won’t the spread of these other diseases likely rise at least to the level of the spread of measles? Oddly, the potential spread of these other diseases from failure to vaccinate is not a subject for public discussion.
On the other hand, a drug resistant form of tuberculosis now strikes 230,000 worldwide annually. And this is after it was widely believed that TB had virtually disappeared through the “wonder drugs” that have up until recently protected us.
Let’s focus on what we might do for our part to help prevent the spread of all this and to save ourselves. Further to that, consider first the recent studies that tell us that doctors’ offices are no refuge when it comes to germ-filled environments.
The National Institutes of Health, after screening well over 1,000 studies and then carefully reviewing 72 of them, found that healthcare personnel in non-hospital settings unwittingly contribute to the risk of “pathogen transmission” through their clothing and the devices they carry, particularly white coats, neckties, stethoscopes and the increasingly commonplace mobile electronic devices. Their clothing, along with these devices, gets contaminated even with the wearing of gloves.
Microbes have always lived among us. Most are harmless, and many help us in ways we are just beginning to appreciate. For generations, however, we have indulged in an antibiotic craze, not only with ourselves and our children, but also with livestock and food crops. While doctors and farmers in most of the Western Hemisphere are curbing antibiotic use, it continues to intensify in many other parts of the world, encouraging bacteria that antibiotics no longer kill — super-germs that travel the world with ease and speed.
Add to this the decline of competition among microbes, a natural competition that once controlled the growth and spread of harmful bacteria. This competition declines continuously in a world of antibiotics, further paving the way for super germs. A United Nations report offers the conservative estimate that these super bacteria, now causing 700,000 deaths, will kill 10 million people annually by 2050.
Every year in the U.S., 5 to 10 percent of patients catch a hospital-acquired infection, hitting hard, among other things, our struggling health care system.
But we cannot get overwhelmed by these reports. One source for guidance in this world of health care-turned-upside-down is “The Handbook: Surviving in a Germ-Filled World,” by Miryam Wahrmen, a professor of biology at William Paterson Univeersity. This book is an eye-opener, well documented and superbly readable — a must-read for both patients and providers. Wahrmen and others offer these tips that are as effective as they are simple; each of us must take these guidelines to heart, and embrace them as a matter of habit:
- It’s so routine to sign in at a doctor’s office that we give it no thought – recognize that the doctor’s receptionist’s pen is a germ-ridden cesspool — bring your own pen to sign in and keep your hands off the clipboard; if they use a smart pad at the office, wash or sanitize hands right after using their stylus;
- The arms of a waiting room chair or couch abound with germs; keep hands and arms off them, or wash or sanitize hands afterward;
- if you like to shake your doctor’s hand, change to a “fist-bump,” and you will reduce the transfer of germs by 90 percent:
- The circular part of the stethoscope – a/k/a the “bell” – is so germ-ridden that it’s worth reminding your doctor to clean it; nurses are usually consistent with this cleaning, but many doctors are not;
- Door handles are always germ-ridden, but especially at the doctor’s office, and none more than their bathrooms, especially where patients give urine samples; definitely keep tissues in your pocket to grip those door handles;
- After playtime, sanitize children’s hands at a pediatrician’s office where they provide toys.
We can do this, even as these new and deadly diseases travel the world in an astonishingly short amount of time. The more who take it seriously, the safer all of us are. We cannot forget that hygiene lapses by medical professionals, as well as ourselves, can lead to serious, even fatal complications.
And taking it seriously does not stop at hospitals and doctors’ offices. Adopt these simple, hygienic precautions before and after preparing food, or caring for one who is sick, in order to protect yourself, your families and others. Yes, the extent of these spreading super germs can be cause for alarm, but a consistent, cautious attitude, coupled with keeping our own immune systems strong, will prove an excellent advantage for each of us.
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