Brian Baer / bbaer@sacbee.com

Cindy Gaston developed a serious infection after a C-section. She testified in favor of legislation that will require hospitals to screen at-risk patients for MRSA starting Jan. 1.

Capitol and California
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State's hospitals must come clean on germs

Published: Saturday, Dec. 27, 2008 - 12:00 am | Page 1A
Last Modified: Saturday, Dec. 27, 2008 - 9:34 am

Second in a series of new state laws that take effect Jan. 1.

On her second night home after giving birth by Caesarean section to her fourth child, Cindy Gaston's incision burst open and pus began oozing out.

Doctors at Mercy San Juan Medical Center in Carmichael, where she had given birth, later determined she was infected with methicillin-resistant staph aureus, or MRSA.

The strain of a once-innocuous staph infection that has become invulnerable to first-line antibiotics kills more people each year than the AIDS virus and in most cases is contracted in hospitals.

Beginning Thursday, legislation will be phased in requiring all 400 hospitals in the state to implement tougher infection control practices to stem outbreaks.

"I had never even heard of MRSA or that there was a risk of becoming infected with it in a hospital," said Gaston, who lives in Elverta.

The federal centers for Disease Control and Prevention estimates 2 million patients contract an infection in hospitals every year and nearly 100,000 of them die. As many as 9,600 of those deaths occur in California, according to the state Department of Health Services.

Senate Bill 1058 by Sen. Elaine Alquist, D-Santa Clara, will require hospitals to publicly disclose their infection rates and screen certain high-risk patients for MRSA.

"The heartbreaking thing is this is something than can be prevented with something as simple as hand-washing," Alquist said. "Hospitals ought to be safe places to go – you shouldn't go in and then die from something else."

Senate Bill 158 by Sen. Dean Florez, D-Shafter, gives the Department of Health Services additional authority to investigate infection outbreaks and complaints about lax infection control practices.

"These important measures will help save lives and health care dollars by reducing the number of infections that people are exposed to while staying in the hospital," Gov. Arnold Schwarzenegger declared when he signed the bills.

Alquist was particularly moved by a meeting she had with the parents of Nile Moss, an Orange County teenager who died from a MRSA infection after a visit to the hospital where he got an MRI.

Even the famous are not immune. Tom Brady, quarterback for the three-time Super Bowl champion New England Patriots, contracted a serious infection after undergoing knee surgery at a Southern California hospital. Brady required a second surgery to clean out the infection.

One of the driving forces behind the legislation was Consumers Union, publisher of Consumer Reports. Betsy Imholz, director of special projects for Consumers Union, said 20 states have passed public disclosure laws.

Imholz said that until this year, hospitals in California had resisted similar efforts, citing costs.

"I think what really pushed us over this time was years of hard work," Imholz said. "We also had thousands of individuals like Cindy who've been personally affected and learned to walk the halls (of the Capitol), testified at hearings and sent thousands of e-mails."

Debby Rogers, vice president of quality and emergency services for the California Hospital Association, said there's "a misperception that we were resistant."

"We worked very hard with (Alquist) and the constituent groups to try to craft a workable bill," Rogers said.

She said hospitals will incur added costs to collect infection data and screen for MRSA.

"This will be challenge in an environment where there are shrinking health care dollars, we have the lowest Medi-Cal reimbursement rates and hospitals prioritize where they're going to spend resources," she said.

Rogers said hospitals in the state have been working "very hard" to curtail infections. But some cases are inevitable, she said.

"Hospitals are places where sick people go, where immunocompromised patients go – so they're more predisposed to infections," she said.

According to supporters of the legislation, hospital infections add a staggering $3 billion to health care bills in California each year.

Beth Capell, a health care lobbyist, said the legislation was bolstered by a "growing recognition by many employers that hospital-acquired infections and other preventable conditions are increasing health care costs."

Preventing MRSA infections in hospitals can be as simple as conscientious hand-washing, isolating infected patients and using disposable gowns and gloves in their rooms.

Some hospitals do a better job than others at stopping them. But according to the National Quality Forum, hand-washing compliance rates at hospitals are generally less than 50 percent.

SB 1058 will require hospitals to report infections such as MRSA to the Department of Health Services, effective Jan. 1. The information will be made available to the public through the department's Web site beginning in 2011.

Screening of at-risk patients for MRSA will begin with the new year. Beginning in 2011, these patients will be screened prior to discharge to determine whether they were infected while in the hospital.

SB 158 will require hospitals to provide continuing education and training for workers, including conducting hand-washing campaigns.

Gaston, who required three surgeries to clean out her infection, was surprised by the sometime poor infection control practices she observed during her hospital stays.

While her visitors were required to put on disposable gowns, hospital workers who brought in her food and cleaned her room did not put on the gowns.

"People should not have to endure these kind of infections, especially from a place where they went to get well," she said. "My hope is this legislation will prevent a lot people from having to suffer like I did."


Call Aurelio Rojas, Bee Capitol Bureau, (916) 326-5545.


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