AUDIE CORNISH, HOST:
We're going to hear now from one hospital that dealt recently with a major deadly outbreak of a superbug. Starting in July 2011, an infection swept through the 240-bed hospital run by the National Institutes of Health in Maryland. Seven died from the bug. Here to talk more about how procedures have changed at the NIH and how they've avoided another outbreak since then, we're joined by Tara Palmore.
She is an infectious disease physician at NIH, who coordinates efforts to avoid hospital-borne infections. Welcome to the show.
TARA PALMORE: Thank you for having me.
CORNISH: Now, after the outbreak happened at NIH, can you give us some examples of a change in practice that you had to instill in staff?
PALMORE: So before the outbreak, we used standard hospital disinfection techniques. And after the outbreak, after seeing how easily transmitted the bacteria were, we've been extra-aggressive to disinfect and decontaminate the hospital environment. For example, we use hydrogen peroxide vapor to decontaminate the patient rooms of anyone who has harbored these resistant bacteria. And when we have occasionally isolated the resistant bacteria from the drains in the sinks in those rooms, we have taken out the sink drains, disinfected them heavily with bleach and replaced them and replaced some of the parts of the sink.
CORNISH: Are there any cultural shifts that you had to make in the hospital staff to kind of - everyone's in the habit of doing things a certain way and you had to say, look, we need to - you need to look at this differently?
PALMORE: We really had to instill in the staff that 95 percent adherence to hand-washing protocols was not good enough, that we really had to have 100 percent; that that five percent missing was the five percent that could potentially transmit resistant bacteria.
CORNISH: How do you make sure everyone is washing their hands?
PALMORE: When we have patients who are carriers or who are infected with these resistant bacteria, we actually hire adherence monitors to watch every health care worker who goes into and out of those patients' rooms.
CORNISH: So it's a hall monitor. You literally have someone who's there just looking at everyone and saying, hey, did you wash your hands?
PALMORE: It's a hall monitor. And whether you're the chief surgeon or whether you're another hall monitor, they will exact the same standards of hand hygiene and disinfectant of medical equipment.
CORNISH: And when it comes to patients, what about testing them for these superbugs? How often, how does that work?
PALMORE: In certain high risk units in the hospital, we test people twice weekly. We also test people who are transferred to our hospital from other health care facilities because we know that being in health care facility is a risk factor for having these bacteria. And once a month, we actually test almost the whole hospital.
CORNISH: Now, you've been studying infectious diseases for a long time. What is the thing that most concerns you about the development of these superbugs?
PALMORE: The lack of new antibiotics is the thing that keeps me awake at night. In many cases, the bacteria are susceptible to only one or two antibiotics. And those antibiotics may be very toxic and cause a host of side effects that make the patient ill, alongside the infection. So developing new, novel mechanisms of antibiotics is, I think, one of the most important goals to prevent these bacteria from exacting an even higher mortality rate.
CORNISH: Tara Palmore is deputy hospital epidemiologist and infectious disease physician at the NIH. Tara, thank you so much.
PALMORE: Thank you. Transcript provided by NPR, Copyright NPR.
