Why are hospitals such germ pits?

Factual Questions
21

You’re talking about a lot of surfaces, and cleaning crews can’t come through all the time and clean every few minutes or so. You just need to give some bacteria a foothold in one spot for long enough for someone else to touch it and move it along. I’ve read reports that say that doctors’ ties and white coats can be pretty damned germy since they don’t get laundered that often. (Looking at my own white coat hanging on the back of my door, I can attest to that.)

The cleanser may not be in place for long enough to work before being wiped away, or might not get into the cracks and crevices harboring bacteria. People might misunderstand the effectiveness of a hand-cleansing product - that alcohol-based hand sanitizer is great, but not 100% effective - or not wash long enough to scrub away all the bacteria, or might scrub long and hard but some bacteria stayed under their nails and later works its way out when they’re ungloved.

Plus there are places that germs land on which people don’t really think about, and which can’t be cleaned in that fashion, like patient charts. I’m very certain that when I worked in pediatrics, I would catch the kids’ colds - without ever seeing 99% percent of the kids - by handling the charts after they came back from the clinic. Kid coughs/sneezes in exam room near chart, or hugs nurse/holds nurse’s hand/shakes doctor’s hand, or the doctor or nurse picks up the viruses by just examining the kid, then touches the chart. Unthinking me would pick up the chart to deal with it as needed, and later touch my eye/lips, and presto, cold transmission. Get enough of those surfaces and enough unthinking people who move germs from there to elsewhere, and you have a great vector for disease.

As previous posters stated, most “superbugs” flourish only when you’re dealing with an immune-compromised or otherwise very ill person. The sheer amount of other competing “bugs” that are out there will crowd it out, and your immune system will keep it suppressed too - it might not feel like it at times, but you don’t catch every cold, etc., that you’re exposed to. Most health care workers’ families are more or less healthy like the average person, and so unless they’re very unlucky or unwell, they’re not very likely to catch it either.

22

I also heard that some of the innovations in modern hospitals make things worse…like replacing those grungy-looking brass dorr handles with nice clean shiney stainless steel! It turns out that the copper in the brass door handles was germicidle , while bacteria can stay alive ob SS for days!

23

Right! We always like to go to the nearest hosptital when we want a nice meal. :smiley:

24

The answer is evolution.

Bacteria reproduce really fast – 20 minutes per generation is the number I see bandied about, although obviously that’s going to be a rough estimate. Like all living things, when a bacterium reproduces there’s a small chance its offspring might have genetic mutations. Just because of the roll of the dice, some tiny tiny number of these mutants will have the mutation of immunity to Lysol. (Oversimplification, of course.)

Now, if you leave the surface where these guys live alone for a while, there are all these bacteria burrowing about for whatever food is available. The Lysol-immune beasties don’t have any particular advantage in just hunting for food and surviving in normal circumstances, so their population is going to remain small because competition for resources is tight.

But then someone wipes down the table with Lysol and a paper towel. 99.9% of the germs (or some similarly huge numer) are killed instantly. But who survives? The one or two of them who are immune to Lysol. Now, of course, there’s no more competition for resources – all the food that had been there supporting a population of a million bacteria is now available only to the few hundred, say, who survived the Lysol purge. And so they multiply like mad with no scarcity to stand in their way. So a week later, the population is back up to the original numbers. But now that same number of bacteria is made up almost entirely of bugs that are decended from Lysol-immune parents. Of course, almost all of them will retain that genetic Lysol immunity, meaning spraying with Lysol isn’t going to do a damn thing anymore to stop their growth.

Similar processes exist for antibiotics – many patients have germs, they get antibiotics to kill the germs, and while it makes the patient well, there are just one or two of the little buggers who happened to have evolved immunity to that medication. Then, as those bugs circulate through the hospital, you’ve now got a large population once again descended from the small number of superbugs that happened to be strong enough to survive the purge.

Repeat over 50 years, and you have folks catching MRSA in hospitals.

–Cliffy

25

This is one of the reasons that it bugs me to see people bringing in their little kids to hospitals.

Ok, Ok, I know it’s a very nice thing to do, and it brightens up Grampa Karl/Aunt Veronica/Cousin Lester’s day, but, really, hospitals aren’t the place for little kids. Sure, the patient they’re visiting might be in the hospital recovering from a unfortunate unicycling accident, but the patent in the next room might be in there for something pretty nasty.

When I think about the number of MRSA/VRE/TB/C. diff patients I see each day, plus those patients that are hacking up a lung while in the waiting room, all I know is that my son can wait for me outside.

26

Guys, it’s not just the staff or the patients, or the bad practice of the cleaning crew.

Most hospitals now have open visting hours, as opposed to the old days, when visitors came for an hour or two. Not all visitors are good about hygiene either, not everyone washes their hands before or after they enter a ward, not everyone washes their hands after touching the patient, not everyone is there to visit just one person.

So, you’ve got patient A with, being fed grapes by relative A, who didn’t wash their hands when they went to the bathroom.

Patient A borrows magazine from patient B, gets germs on magazine. Patient B’s relative reads magazine after Patient A returns it, gets germs on hands, then picks at grapes in patient B’s bowl, transferring germs to grapes and their mouth. Relative B then kisses patient B goodbye.

Relative A (who, you will recall doesn’t wash up after they use the bathroom) uses vending machine, gets germs on vending machine buttons. Relative C touches vending machine buttons- then handfeeds chocolate bar to patient C- their sick child.

Relative D comes in to visit their newborn baby, and also their father, who is in the same hospital after surgery. Patient D (the father) is elderly, and has difficulty going to the bathroom alone, his son helps him, but doesn’t wash his hands properly. Relative D then visits his new baby and his wife, who is recovering from a c-section. Baby and wife are kissed and cuddled, and baby is given dad’s finger to suck.

All the relative get hungry and go to the cafeteria- where they sit at the same table, use the salt shaker and touch the chairs, tables and trays- leaving the germs from their hands there for whoever next sits there.
You think I’m making this stuff up- one of my microbiolgy professors tells a story from the 1970s, when they still used the old 24 bed Nightingale wards. This was in a London hospital and everyone was puzzled why only the 4 Irish patients on the ward got a severe case of diarrhoea, considering they were all in with different things and at different ends of the ward. The culprit turns out to have been a copy of “Irish Life” magazine, which all of them had read, and which was acting as a reservoir of infection.