Health. Care. | An Educational Blog

Today's trio of pathogens are stealthy, living on our bodies without causing us harm but wreaking havoc when they find a way inside a bacteria-free, or sterile part of our body (lungs, bloodstream, internal organs, and others). Typically they are surrounded by other species of bacteria in our intestines or on our skin, using all their energy to battle it out for resources with the other species of bacteria that surround them. This keeps them in check. However, if they are able to enter the sterile parts of our body through an incision or medical device, they find themselves in a new territory with absolutely no competition. With uncontested resources, they quickly reproduce and create an infection which can cause great harm, and even death.

New England has been put on high alert thanks to an outbreak of Eastern Equine Encephalitis (EEE), a rare virus that can lead to the deaths of 30% of those infected, and leave many survivors with neurological problems. Despite the name, (the second E, equine, means "horse") this virus is spread by mosquitos, an example of what is known in the medical field as a disease vector. In today's post, we'll look at what a vector is, and how they play a role in the spread of healthcare-associated infections.

It is estimated that there are  5×10³⁰ bacteria on Earth. That's 5,000,000,000,000,000,000,000,000,000,000, or 5 nonillion. We have not even begun to identify them all, and new strains are evolving all the time. We not only coexist with bacteria on Earth, they outnumber us by such a mind-boggling degree that we cannot even conceive it. Consider this: There are currently just over 7 billion humans on earth, and one spoonful of rich soil contains approximately 10 trillion bacteria. And our bodies? Bacterial cells outnumber human cells 10 to 1. (But don't worry, you're not a zombie. They make up only 3% of our body mass. But still.)

In formal descriptions of the germ-fighting powers of antibacterial and biocidal products, the terms "Gram positive" and "Gram negative" are used as a way to categorize bacteria. While there are estimated to be over 10,000 species of bacteria, they can be categorized into a few helpful categories.

One of those categories has to do with the structure of the cell membrane. All the known bacteria fit into one of two categories of cell membrane structure: Gram-positive or Gram-negative. But what does that mean?

Will they or won't they? This was the question at the Olympics in Paris, France this past week as swimmers and fans waited to hear whether the famously polluted Seine River would be clean enough to hold races safely. The verdict? A hard... maybe? The Olympics served as a goal post for France, which pledged to clean up the Seine upon being selected to host the Games back in 2015. $1.5 Billion later, the Seine has seen great improvement, but bacterial contamination continues to plague the busy waterway 7 out of 10 days, on average. In today's post, we'll learn how this waterway became so contaminated, and why bacterial contamination can be so difficult to eradicate in urban riverways.

We hear so often how "we all have a role to play in reducing healthcare associated infections." From washing our hands to advocating for policy changes, it can often feel overwhelming. One way to make our impact more practical is to identify the things that we are uniquely able to do in our current position. In a series of posts starting today, we will explore the actions we can take to reduce infections most effectively based on our professional role in healthcare. We hope these ideas serve as a springboard for your own choices in the future.

To address the persistent issue of healthcare associated infections, hospital professionals deploy two primary approaches: reactive and proactive solutions. There are advantages and disadvantages to both options, so a combination of the two is required to cover all reasonable contingencies. In this blog post, we'll explore the differences between these two strategies and their respective impacts on patient outcomes and healthcare systems.

Access to clean water, soap, and basic cleaning products may seem like a given in our nation, leading many of us to overlook the impact poverty can have on hygiene. In the United States alone, the statistics are staggering: 33% of low-income households report bathing without soap when they can't afford it, 32% report reusing diapers, and 74% skip doing laundry or dishes to save on supplies. It can seem that hygiene products are not as great a priority as nutrition, shelter, or clothing, but hygiene has a direct impact on health, especially for those struggling with a chronic condition or patients receiving "hospital at home" care. In this blog post, we will explore this concept of "hygiene poverty," its consequences, and the urgent need for collective action.

About a quarter of American hospitals are for-profit, that is, they are operated to generate profit for owners and stakeholders. A subsection of those hospitals, about 3%, have been acquired through private equity (PE) buyouts, whereby a PE firm raises funds to purchase a hospital. These PE transactions, also called "takeovers," are characteristically funded through leveraged debt - the firm takes out a loan secured by the purchased entity (the hospital), adding the burden of that debt to the balance sheet (and monthly expenses) of that facility. As a result, hospitals acquired by PE firms face additional pressures; they are operated not only to generate profit but also must repay large amounts of debt, used to fund the acquisition and now added to their balance sheet. A recent study looked into this subsection of hospitals to see how this added financial pressure impacted patient outcomes. The results? Patients are 25% more likely to be harmed by medical care at a private-equity acquired facility.

In our series on Clostridioides difficile, we explored the bacteria that causes this lethal hospital-acquired infection, the resulting infectious disease, and the outlook for treatment and prevention. This Thanksgiving week we are providing a shorter read and offering this one-page infographic that presents the highlights of this series on one shareable page. The cycle of infection as well as the lifecycle of the microorganisms are presented in relation to each other, with the added element of where either of those cycles can be broken, preventing an outbreak.