Gehrke survived but it took seven months when all was said and done for the infection to clear up and the wound to heal. She says she was bedridden for a total of six months and racked up $13,000 in out-of-pocket expenses for home care and procedures associated with her infection.
"My credit is shot," says Gehrke, who works as a server at a local restaurant and whose husband works as a diesel mechanic for Wal-Mart. Their combined salaries amount to about $34,000 annually before taxes.
Gehrke asked her ob/gyn why this had happened. "'These things happen in hospitals' is pretty much what he told me," she says.
It is difficult to pinpoint the source of Gehrke's infection. It may have stemmed from a dirty instrument used during her C-section or from unwashed hands or the contaminated gloves of a health care worker. But one thing is almost certain: she picked up the bug at the hospital.
Gehrke is one of millions of patients who have unwittingly contracted infections in hospitals, where they went expecting to get well—but instead got sicker. Every year nearly 100,000 people die of infections they developed in U.S. hospitals and healthcare facilities, a greater number than those killed in homicides and car accidents combined. Some 1.7 million patients contract hospital infections annually, according to the most recent data from the Centers for Disease Control and Prevention (CDC).
Many of these infections are caused by multidrug-resistant superbugs such as MRSA and vancomycin-resistant enterococci (VRE). Heavy use of antibiotics in hospitals encourages the emergence of stronger and stronger bacteria. Exposing a bacterial strain to one antibiotic essentially weeds out the weak and selects the hearty bugs that can survive. Then the next generation of antibiotics is called on; eventually the bugs become resistant to that as well and the bacteria continue evolving until eventually no antibiotic can kill them. "You can end up with bugs that we really don't have medications to kill," says Allison Aiello, assistant professor of epidemiology at the University of Michigan School of Public Health. Experts estimate that more than 70 percent of all hospital-acquired infections are caused by bacteria that are resistant to at least one of the drugs commonly used to treat them.
Hospitals not only provide optimum conditions for the evolution of superbugs, but they also provide a plethora of inviting pathways for bacteria to get inside human bodies: open wounds from surgical incisions, catheter tubes running in and out of blood vessels and urinary tracts, and ventilators inserted through noses or throats and into windpipes.
What's most shocking about hospital infections, experts say, is that most of them can be avoided. "The vast majority of all hospital infections are preventable," Bancroft says. In the past, "the mantra was that hospital infections are inevitable," she says, but the attitude is changing because many hospitals have proved it wrong.
In 1978 the University of Virginia (U.V.A.) Medical Center in Charlottesville had its first case of MRSA. The bug spread from patient to patient despite the fact that health care workers were washing their hands after touching bodily fluids as well as donning gowns, gloves and masks when caring for patients with clear signs of MRSA infections (such as pus-discharging wounds or pneumonic coughing), says Barry Farr, who was a medical resident at the time and is now professor emeritus of U.V.A.'s Department of Medicine. By 1980, nearly half of the hospital's staph infections were caused by MRSA.
In an effort to control the problem, the hospital decided to actively seek out and isolate not only patients infected with MRSA but also those who were colonized, meaning they carried the bug on their skin or inside their noses, sputum or urine. (People who are colonized may be carrying millions, if not billions, of bacteria that can easily spread to others, either through direct contact or by touching common surfaces such as bed rails, doorknobs and blood pressure cuffs). U.V.A. began testing all high-risk patients for MRSA infection and colonization; those who tested positive were placed in contact-isolation areas with warning signs on their doors alerting health care workers of the patients' contagious status and instructing them to wash their hands after touching them. (The CDC did not even recommend hand washing before and after all patient contacts at this time.) Using active detection and isolation, U.V.A. had totally wiped out MRSA within 18 months, Farr says. "I watched this work at U.V.A. in 1980 to 1982" and "there was no question that it worked."