Gram-negative bacteria threatens sickest patients

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As hospitals continue to battle rogue infections like MRSA and C. diff, which continue to pose substantial threats of their own, another threat is emerging that poses a threat to the sickest patients in their populations. While most infection-control efforts have been focused on gram-positive organisms like MRSA, which may still be killed by some antibiotics, fewer are focusing on gram-negative bacteria.

Gram-negative strains, which are becoming ultra-resistant to antibiotics as they change, are attacking patients with weak immune systems, such as burn victims, cancer and AIDS patients, severely injured people and premature infants. Key threats include acinetobacter baumannii, enterobacter aerogenes and pseudomonas aeruginosa. These organisms can attack through wounds, surgical incisions, central lines, respirators and catheters. Worse, bacteria like acinetobacter are becoming resistant to carbapenems, the last possible defense for these bugs.

Consistently performing key preventive actions can help enormously. One program fighting bloodstream infections in Michigan ICUs cut infection rates 66 percent over 18 months and saved more than 1,729 lives by performing such actions, including handwashing; draping patients before inserting central lines; cleaning skin properly; and avoiding groin catheters and removing them as soon as possible. It also saved $246 million.

To fight these germs, hospitals are also screening patients as they arrive; sterilizing equipment with new approaches, bathing ICU patients with chemical antiseptics and insisting that workers wear protective equipment when caring for at-risk or infected patients. They're also controlling antibiotic use, as excessive use can breed drug-resistant bugs.

To learn more about this issue:
- read this Wall Street Journal piece

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