Family: Hospitals should reveal risks of ‘superbug’

Carolinas Medical Center
Carolinas Medical Center mhames@charlotteobserver.com

The family of an elderly Lincolnton woman who died from an antibiotic-resistant “superbug” that has seen recent cases across the country said they wish the hospital had told them the potential risks before she contracted it.

Alda Crump, 88, of Lincoln County is one of two local people who have died in recent months after contracting carbapenem-resistant Enterobacteriaceae, commonly known as CRE. In a news conference Sunday, Carolinas HealthCare System officials said more than a dozen others also have been sickened by the bacteria.

Citing medical privacy laws, Carolinas HealthCare officials did not release specifics about the people who have died from CRE.

Because of the threat, officials said, the Charlotte-based hospital system has started screening patients from populations likely to have CRE. Once identified, CRE patients are isolated from other patients. When they’re released, the hospital takes extra steps to decontaminate their rooms. Even so, three people have acquired CRE at Carolinas HealthCare System hospitals this year, officials said Sunday. An additional 15 have come into hospitals with existing CRE infections.

On Monday morning, Crump’s family recounted to the Observer the months leading up to her death.

Jerry Church, Crump’s son-in-law, said she went to the hospital in early December for a urinary tract infection. She was released before Christmas, he said.

Just before New Year’s, Church said Crump went back to the hospital, which is when she found out she had contracted CRE.

“It got progressively worse after the diagnosis,” he said. “At that age, you have a lot of issues with pain and this and that, but it seemed like whatever was bothering her was exacerbated.”

The family of bacteria that includes CRE is highly resistant to antibiotics and difficult to treat. Some strains can kill half of the people they infect, according to the Centers for Disease Control and Prevention.

CRE has been reported in all but three states, according to the CDC. Last week, the University of California at Los Angeles reported that 179 patients at Ronald Reagan UCLA Medical Center were exposed to CRE during endoscopic procedures between October and January. The bacteria may have contributed to the deaths of two patients, according to the university.

CRE typically affects the sickest patients – people in long-term care facilities or who use devices like ventilators and urinary catheters for long periods of time. Endoscopes like the ones used at UCLA have also been scrutinized, and Carolinas HealthCare has changed how it cleans the devices.

Over the next several weeks after Crump’s diagnosis, Church said, she was readmitted several more times to the hospital.

“It was visible that she was getting weaker and weaker,” Church said.

CDC officials also met with Crump and her family after the diagnosis to explain the bacteria and what extra precautions would need to be taken.

Dr. Katie Passaretti, medical director for infection prevention at Carolinas HealthCare, said the hospital aggressively cleans the rooms of CRE patients who are released from the hospital, even using a device that kills bacteria with ultraviolet light.

Crump died on Friday around 4 p.m., Church said.

“Her heart was broken because she was in the hospital and when her family should have been around there touching and holding her hand, we had to have gloves and aprons on and that was to protect us from her,” Church said. “That’s not the way to spend your last days on earth.”

Hospitals in the United States have been contending with CRE for more than a decade.

About 5 percent of patients, roughly 1.7 million people, get an infection in the hospital each year, and about 100,000 die as a result, according to the CDC. The cost for treatment is high – from $28 billion to $33 billion.

To further encourage hospitals to reduce infection rates, Medicare and Medicaid have stopped reimbursing for the extra care needed to treat some hospital-acquired infections. That means hospitals have to absorb the cost.

Church said he wishes the hospital had made his family aware of the risk of CRE.

“It seemed like everything was hush-hush,” he said. “That concerns me. People could be at risk for something they weren’t aware of.”

Had the family known about CRE, he said, they would have taken extra precautions, such as asking the hospital about how they sterilize equipment.

Church said he hopes some positive policy change comes out of his mother-in-law’s death.

“That’s something she would have wanted, for things to get better,” he said.

Staff writer Karen Garloch contributed.

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