I'm not saying it is good. I'm just saying that there is more than one thing going on here.

I don't think hospitals have any motivation to hide antibiotic-resistant infections ("superbugs") specifically. HOWEVER, the motive to hide hospital-acquired infections[0] is clear!

Here's some mud in the water: what's the difference between a HAI with some bug that is easily killed by antibiotics vs. an antibiotic resistant bug?

As for "tracking it in secret", that's one way to put it, but it will cloud your thinking. :) Your own medical records--specifically blood test lab results--have your name, address, and phone number on them. Consider replacing the word 'secret' with 'private' and re-working the whole thought.

0: http://www.cdc.gov/hai/

You start out by saying that the article is "misleading", and that MRSA is tracked. The article is pretty convincing that it's not accurately reported.

Then you agree with the article that "the motive to hide hospital-acquired infections is clear".

Uhh... That's kind of a huge problem.

Well yeah. But hey, I'm no journalist.

I stand by my assertion that nobody is trying to "hide" the "superbug" problem.

The human tendency to not self-report failures is a thing. But it's not some kind of biohazard conspiracy.

And one more thing about the death certificates...

    > In a statement emailed to Reuters, Frieden said: 
    > "While death certificates provide helpful 
    > information, the unfortunate reality is that they
    > don't provide in-depth clinical information."

I'm guessing that Frieden, the boss of the whole CDC, went on to say something like: "But it makes sense, because death certificates are primarily legal records. The clinical information lives in medical records." OR, OR, something more accurate. That's why he gets the big bucks. :)

Well, you know more about this space than I do. So maybe it's not so bad...

But the article sure makes it sound like hospitals are hiding MRSA-related deaths, since MRSA infections are often "hospital acquired". And we all agree that hospitals would have an incentive to hide these numbers.

And the apparent under-reporting seems to indicate that this is in fact what's going on. This sounds like a problem! Thanks a lot, dishonest hospitals!

Yes, as the article points out:

> There’s also a powerful incentive not to mention a hospital-acquired infection: Counting deaths is tantamount to documenting your own failures. By acknowledging such infections, hospitals and medical professionals risk potentially costly legal liability, loss of insurance reimbursements and public-relations damage.

Yes, I totally get privacy, and I'm glad to read that you're not saying it is good.

It's the hiding it in public records such as Death Certificates, information given to the family, and performance statistics that I find suspicious.

In particular, a potential patient might want to know MRSA case rates when selecting hospitals or other medical treatment facilities.

Or (perhaps more likely) Medicare/Medicaid and/or private insurers might start penalizing the ones that are screwing it up (by renegotiating contracts and reimbursements). I know of one center where executive laziness led to a $2 million fine (completely unjustified) for a line infection in an immunosuppressed patient. Which was cleared up in hours, probably didn't come from the line to begin with, and got said executive fired (because if there's one thing hospital "leadership" understands, it's money).

Actually I have all sorts of examples of the above, but the point is that oftentimes the data is "corrupted" on the way to the collection point(s). Anyways, the executive (VP of some bullshit) got his walking papers and funnily enough, no more reportable line infections that didn't come from lines.

So at least sometimes there are happy endings, sort of...

Sorry, I am a little confused. Why was it a happy ending? Because the VP was just a titular post? Also, looking at your comment, it reads like the problem went away not because the hospital improved, but because the data stopped being reported. This does not look like a happy ending either. And if the line infection was cleared up in hours, how did it also "probably didn't come from the line to begin with"?

The VP was a douche and the "line infection" was almost certainly not from a line in the first place. The patient was on IST, so calling any random opportunistic infection a central line infection is (at best) irresponsible.

Reporting incorrect data can be worse than reporting nothing at all. Here are the guidelines: http://www.cdc.gov/nhsn/pdfs/faqs/faqs-v-6_clabsi.pdf

CLIs are only supposed to be reported when the central line can reasonably be implicated as the vector and the blood is the primary infection site. Neither was established.

As far as cleaning up procedures, there will always be room for further improvement, but that's no reason to accept a $2 million fine (which still had to be paid) as a cost of doing business when the "root cause" was incorrect reporting.