The doctor tells you to go to the local hospital for a routine procedure, just to stay healthy.

When you go in that morning, you feel fine. It is just a simple test, right. You enter the austere waiting room. The tile floor is clean. The smell of disinfectant lingers in the air, and it is strangely comforting because, well, that’s what hospitals are supposed to smell like.

Hospitals are also supposed to be where people get well so facilities are thoroughly cleaned daily to prevent any transmission of infection from patients and staff, aren’t they?

Not always, it turns out. Patients at UCLA Medical Center found out as much last week, when almost 200 people were notified of possible exposure to a bacteria the Centers for Disease Control has put on their Highest Watch List.

Bacteria

Antibiotic overuse is making some bacteria more dangerous.

Flickr.com

If you get a call telling you that you have been exposed to something called carbapenem-resistant enterobacteriaceae, or CRE, you aren’t likely to know what it means, but it sounds unpleasant. And it is.

This rare organism, which has developed a way to resist all known antibiotics, leads to a 50 percent mortality rate when it gets into the bloodstream. It has already been blamed for two deaths at UCLA Medical Center where hundreds of other patients were being treated for possible exposure.

Hospital officials claim they followed all proper decontamination procedures that the manufacturers of the equipment recommended for care of their products. The CDC concurs that those precautions were taken, but that in this case, it just was not enough. Shockingly, other major medical centers admit that they, too, have had outbreaks in the past year.

So the next time you get sick and go to see your doctor in search of an easy antibiotic solution, remember this: Antibiotic pills work best in people who don’t take them very often.

Hawaii has seen this same bacteria. In 2013 the Department of Health warned all medical centers in the islands about the existence of this resistant bacteria found in our hospitals, and the lack of available effective treatments to eradicate it.

Yes, your hospital can make you sick.

To understand how requires a little course in Antibiotics 101. These medications were discovered in the 1920s, starting with penicillin, and they have battled infections to save millions of lives every year.

People who are sick must receive a prescription to get access to these potent drugs, and doctors are warned repeatedly to only use antibiotics when absolutely necessary.

These days plain old penicillin is rarely used in the United States anymore, except for the most basic infections.

Resistant bacteria have cropped up. At first, they were just in hospitals, but they are now found more widely. Terms like methicillin resistant staphylococcus aureus, or MRSA, have become commonplace, as bacteria develops techniques to circumvent the antibiotics that once killed them. Those antibiotics are now often useless.

Despite warnings about antibiotics, patients come in for treatment of infections — even when statistics show that it’s most likely due to a virus. In those cases, Doctors often needlessly prescribe antibiotics. Sometimes, people stop taking the pills as soon as they feel better and leave them in medicine cabinets to be consumed later or expire.

Bacteria develop resistance when they are exposed to antibiotics but aren’t killed. Although you might feel better before consuming a full course of medication, it can lead to bacteria developing resistance to the medication. That means that the antibiotics might not be effective the next time you are sick.

One bacteria can also transfer resistance to the antibiotic to another bacteria, making the situation exponentially worse if the second bacteria over multiplies and causes infection itself.

In the past few years, it has become clear that this also happens in livestock given antibiotics to prevent infection. And this can cause a transmission of resistance to humans, worsening the cycle.

More than 2 million people were infected with resistant bacteria, causing over 23,000 deaths in 2013, according to the Centers for Disease Control. Data is still being tabulated for 2014, but the numbers are expected to be even higher.

All of this takes us back to what happened in California.

Yes, your hospital can make you sick.

Doctors discovered Enterobacteriaceae, a group of bacteria known as carbapenems, which includes E coli and Klebsiella. Carbapenems are resistant to the main antibiotic category that has worked for decades.

During a routine test, the bacteria that were not killed by disinfecting the equipment, spread to other unsuspecting patients, who are now on a medical watch list.

Exposure alone is dangerous, since the resistant bacteria can transfer their ability to resist antibiotics to other unrelated bacteria, spreading the resistant genes even further. These bacteria sometimes prey on the sickest people in hospitals and nursing homes, spread to hospital staff and then to the general public.

It’s that very risk that has focused many scientists’ efforts on trying to discover the next great antibiotic. The holy grail would be one that no bacteria has encountered before and that none could survive.

But in this era of antibiotic overuse, history has shown that once the medication is readily available to doctors and the general population, bacterial resistance will eventually follow.

The day may even come when the very infections that doctors so proudly cured will again be as deadly as they were.

So the next time you get sick and go to see your doctor in search of an easy antibiotic solution, remember this: Antibiotic pills work best in people who don’t take them very often.

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