Op-Ed

Beshear moving to protect Kentuckians from health care-associated infections

Dr. Kevin Kavanagh of Somerset is board chairman of Health Watch USA and associate editor of the Journal of Patient Safety.
Dr. Kevin Kavanagh of Somerset is board chairman of Health Watch USA and associate editor of the Journal of Patient Safety.

It had been a long time since I had talked to health policy advisers in Washington. So when I did so last month, I was somewhat nervous, knowing the stereotypes often placed on someone from Kentucky.

In the past, they have looked down on our health-care delivery system. After all, we are near the bottom of most lists we want to be on the top of.

But when I started the meeting, the opposite occurred. They were almost envious of how Kentucky was able to have the premier health-care exchange, Kynect, and how we were able to drop the number of our uninsured.

Of course, this was due to the work of Gov. Steve Beshear, who also merits praise for expanding protections against secondhand tobacco smoke, and the Cabinet for Health and Family Services. It looks as if our health policy is going to advance even further.

The legislature's inaction on addressing the epidemic of health care-associated infections through public reporting — whose blockage unexpectedly seemed to come from those who expound consumer empowerment and free enterprise — was finally overcome by the courageous actions of Rep. Tom Burch and a forward-thinking governor.

At Burch's request, Beshear is taking action. Revised regulations are underway, which better define an outbreak so it will be harder to not report the data needed to address these epidemics.

The regulations will also give the Kentucky Department of Public Health ready access to information regarding infections once they are reported to the U.S. Centers for Disease Control and Prevention. Presently, unless a facility gives permission, access is delayed, making the information less useful.

There are also provisions which enable health departments to require laboratory reporting of Methicillin-resistant Staphylococcus aureus, also known as MRSA.

But most importantly, there will be mandatory reporting of virtually untreatable bacteria called CRE (carbapenem-resistant Enterobacteriaceae).

And none too soon. It has been more than six years since Sen. Vernie McGaha first tried to institute a bill for reporting and tracking MRSA. The health care industry promised to return with a proposal; none ever came. Assurances were given and an non-coordinated policy to confront MRSA ensued. The result, as in many other states, is a disaster.

The MRSA epidemic continued to grow, largely hidden by the lack of reporting, but apparent to all-too-many families in the commonwealth. The medical profession responded by using stronger and stronger antibiotics. The results have been sobering.

The federal government now requires reporting of MRSA bloodstream infections, a relatively rare event which only represents the tip of the iceberg. That being said, the data show that Kentucky has the fourth highest reported cases.

The five states with the highest rates are all in the Southeast. This finding is supported by the Center for Disease Dynamics & Economic Policy whose data show Kentucky is in the region where almost 70 percent of the Staph aureus cultures are resistant to the antibiotic Methicillin.

Antibiotic resistant organisms are caused by antibiotic overuse and, according to the CDDEP, Kentucky has the highest usage of antibiotics in the United States, more than twice that of California.

As dangerous as MRSA is, CRE is an even greater threat. The CDC has dubbed it the "nightmare bacteria."

A recent analysis of data from the Southeast found that CRE increased five-fold between 2008 and 2012. Currently, it is still confined in health-care centers and has not spread into communities.

If all of this sounds alarmist, remember that only in the past 100 years have we been able to effectively fight epidemics. In June, the World Health Organization warned that a post-antibiotic era is near "in which common infections and minor injuries can kill."

I hope Kentucky's medical industry will support public release of occurrences of these virtually untreatable strains of bacteria.

How can anyone whom the public entrusts to keep them safe withhold this vital information?

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