According to the Center for Disease Control, the fourth leading cause of death among Americans is due to hospital-based infections. Why would infections play a part in in-hospital care when the US leads the world in technology and antibiotic use? The overuse of antibiotics may be one cause of overwhelming infection by antibiotic-resistant bacteria.
In many hospitals, it is common practice for all operating room patients to receive prophylactic antibiotic therapy prior to surgery. Pediatricians will often prescribe antibiotics to children suffering from viral symptoms at the insistence of their parents in spite of the fact that antibiotics have no effect on viruses. It is not uncommon for patients to request an antibiotic for whatever ails them.
What causes infections in hospitals when the environment is supposed to clean and safe? Like a chapter out of Dickens, hospitals are historically filthy, regardless of the amount of cleaning and disinfecting taking place. The sheer number of people present with their various diseases and aliments makes it next to impossible to keep the hard surfaces clean, let alone the soft; which includes mattresses, carpets, drapes, pillows, etc. One of the grossest things seen is carpeting inpatient rooms.
Handwashing is the most important action that can be taken against nosocomial infection, yet it is the very thing lacking in many instances. Doctors going from patient to patient without washing their hands is as disgusting sounding as it is dangerous. Yet it happens continuously. Even the wearing of latex or vinyl gloves is not safe unless the wearer washes their hands in between changes.
Dust collection on shelves, stretchers, patient room furniture, etc, can be a source of disease. The operating room is a treasure trove of bacteria. Bloodborne bacteria are prevalent. A quick turnover of cases can contribute to poor terminal cleaning of surfaces. Patients complained at one facility of blood from a previous case being present on the overhead spotlights.
Poor ventilation, improper cleaning, absence of handwashing, and patient-to-patient contamination are all possible sources of bacteria infection.