Reuters Investigates recently published a multi-part exposé on antibiotic-resistant bacteria, or "superbugs" linked to excessive use of antibiotics. Noting that there is no national database of outbreaks, the reporters filed public records requests in every state to determine how outbreaks of potentially deadly pathogens are being handled. The results were not very promising.
For one thing, only 29 states provided any information at all. The others claimed to have had no outbreaks or to be prohibited by law from sharing the information. The reporters sent additional information requests and drew from academic literature to fill in the picture, and they ended up with one of the most comprehensive counts of superbug outbreaks ever created, albeit one lacking some very desirable information. For example, it wasn't possible to determine how many people have been sickened or killed by drug-resistant bacteria.
The series is well worth reading, and it is far too detailed to summarize effectively here. One important take-away is that no clear definition of the word "outbreak" exists. So, although most states require outbreaks to be reported, the question of whether an outbreak is occurring is left to the judgment of individual doctors and nurses.
C. difficile kills 8 at nursing home, staff not sure it's an outbreak
Reuters cites as an example one case in another state in which healthcare facilities are required to report suspected outbreaks within 24 hours. In that case, a nursing home with 86 residents started seeing patients with symptoms of C. difficile, a highly contagious, often-deadly superbug that is relatively common at healthcare facilities.
C. difficile is common enough that it should be easy to spot. The symptoms of the infection include abdominal cramps, violent diarrhea and fever.
Between January and the end of February, 2014, six residents had the symptoms, and C. difficile was confirmed.
When an employee contacted the health department, however, they specifically stated there was no outbreak. The employee was only seeking advice, apparently, on how to treat "a few cases of C. difficile." Even when the health department followed up, staff at the nursing home denied there was an outbreak. Ultimately, eight people died among 15 infected -- a fact that only came to light in the Reuters report.
Unfortunately, many healthcare providers are in the habit of withholding information when they're not required to release it. While some honest folks may be protecting patient privacy, it's likely that others play their cards close to the vest in order to avoid malpractice claims.
Every year in the U.S., however, hundreds of thousands of people become infected with C. difficile and other antibiotic-resistant pathogens. Tens of thousands die. We need better information if we're going to fight outbreaks effectively.