While health-care related infections have been decreasing in recent years, there are two potentially life-threatening bacterial infections in Virginia that are on the rise.
One causes diarrhea and can lead to serious complications affecting the colon, kidneys and other organs. The other is caused by the same bacterial infection that causes strep throat, with illnesses ranging from patients who have no symptoms to those who experience organ failure.
And both could be prevented with better hand washing practices in hospitals, nursing homes and other health care settings.
The first is Clostridium difficile, or C. diff, which can cause mild to severe diarrhea. Left untreated, patients experience dehydration that can lead to serious health issues. Nationally, 14,000 deaths are linked to C. diff each year. The number of cases is at a historic high.
In Virginia, hospitalizations for C. diff have more than tripled in the past decade, according to Virginia Health Information. Treatment is expensive and typically involves an extended hospital stay. The total hospital cost for Virginia patients diagnosed with C. diff was over $157 million in 2009, according to VHI’s analysis of hospital data.
The other bacterial infections on the rise are Group A Streptococcus, or GAS. While it is a common cause of noninvasive diseases like the painful, but treatable strep throat, it can also cause invasive disease. As an invasive disease it can lead to severe, sometimes life-threatening, situations where the bacteria are found in a person’s blood, muscle or lungs. Two of the most severe, but least common, forms of the invasive disease are necrotizing fasciitis, where the bacteria destroy muscles, fat and skin tissue, and Streptococcal Toxic Shock Syndrome, which causes a rapid drop in blood pressure leading to organ failure.
The Virginia Department of Health requires doctors to report these invasive cases. And with that reporting, public health officials have warned that the cases are on the rise.
The five-year annual average of reported cases increased 71 percent, with 174 cases being reported on average during 2007 and 2011 compared with 102 on average during 2002 to 2006.
Most cases of both C. diff and GAS can be traced to patients being exposed by the health care system. And both are often associated with instances of people failing to follow the simplest of infection control practices: hand washing.
For both, the cause of the infection can often be traced to health care providers not cleaning their hands before and after caring for a patient.
That’s what health investigators found when studying the four outbreaks of invasive GAS that have occurred at Virginia long-term care facilities and hospitals so far this year, according to this account that was sent to providers last month.
Many doctors, nurses and other health care professionals simply don’t wash their hands. While measuring hand washing compliance among health care professionals is complex, the Centers for Disease Control and Prevention suggests that less than half of providers wash their hands. A New York Times blog post last year reported compliance rates for hand washing in American hospitals are around 40 percent.
There are other measures that help to prevent both diseases, but the emphasis is on preventing the spread of illness by keeping hands clean.
For C. diff, doctors are also being urged to be responsible in prescribing antibiotics, because the disease typically hits people who are taking antibiotics for other illnesses. The drug wipes out other beneficial microbes, and that lowers the body’s ability to fight off C. diff.
With GAS, Virginia health officials have also focused on warning hospitals and nursing homes to be cognizant of staff and visitors who have flu-like symptoms and keeping them away from the facility. Additionally, improper care of wounds is also associated with GAS outbreaks.