> Perhaps most terrifying is that the mere act of hospitalization will likely be the highest vector of transmission of nearly untreatable infections. Go in for a routine procedure and end up in the isolation ward due to some highly infectious, deadly disease.

This is one reason to avoid hospitals at all cost. It's also why hospitals are terrible as a first treatment option for the poor. I can't recall a family hospital trip where someone didn't catch something new at the hospital.

> This is one reason to avoid hospitals at all cost.

I think generally, everyone avoids hospitals at all costs.

Good point. And hospitals themselves are very costly. In case you need another reason.

This, right here, is the biggest issue. Routine, minor surgery? No longer a risk free proposition. This sort of antibiotic resistance will have, and is having, enormously deleterious effects on the kind of basic health care and medical science we take for granted.

Fun fact: modern plastic surgery -- including purely cosmetic, non-normative surgery -- predates both antibiotics and anesthetics.

That's not too surprising. People sometimes have ugly face moles and stuff, and it's not too hard to cut it off.

This is what I don't completely understand. Why has no one developed a disinfectant spray that hospitals can apply ad-nauseum (pun intended, the smell ideally wouldn't make people nauseous) all over the hospital? Or, do I not understand the vectors properly?

The way I perceive these stories is that hospitals are actually extremely dirty on a microbial level (as is most of the world), it's just counter-intuitive because I think a lot of people take for granted that a hospital is imagined to be a super sterile place. MRSAs could potentially reside on every surface; an act as simple as touching a bed railing could get you infected. You then have patients in recovery with healing wounds/depressed immune systems, which need antibiotic treatment of some kind when they have an infection. But it's not like you cannot become infected by a MRSA outside of a hospital, you can, and the same antibiotics won't work effectively for you just as they don't work effectively in the hospital. So the first step in my mind is making sure the hospital is 'clean'.

We do. We have disinfectant sprays, chlorhexidine, bleach, UV radiation shot by Cylon looking robots, and surfaces made of copper and patterned after shark skin.

Bacteria are just bloody durable, and people are shedding new bacteria into the environment at really absurd rates.

>We have disinfectant sprays, chlorhexidine, bleach, UV radiation shot by Cylon looking robots, and surfaces made of copper and patterned after shark skin.

And the bacteria which survives all of this, i think it should look something like this:

http://www.imdb.com/media/rm617979392/tt0088944?ref_=ttmi_mi...

It actually looks like this: http://upload.wikimedia.org/wikipedia/commons/0/0f/Clostridi...

> Why has no one developed a disinfectant spray that hospitals can apply ad-nauseum (pun intended, the smell ideally wouldn't make people nauseous) all over the hospital?

We have robots that do that now.

http://loyolamedicine.org/newswire/news/uv-light-robots-kill...

That kind of solution is part of the problem. Resistent bacteria are normaly outcompeted by non-resistant ones, except when there is antibiotics on the enviroment. As a consequence, the mere act of keeping something always sterilized (as well as possible) helps the resitent bacteria growth.

But, of course, you can't avoid keeping a hospital sterilized.

Google for "mrsa aerosol transmission".

Yes yes make everyone wear gas masks and space suits the entire time, staff and patient alike...

The return of the sanitarium and things like leper colonies could be in our futures.

And they'll be absolutely necessary. The infrastructure exists now. As an example, if you contract XDR tuberculosis you will be quarantined under orders from the CDC, by force if necessary, until the infection is cleared, which can currently be done reliably only with surgery.

Maybe the solution is to have the procedure in a place that is a hospital. You'd want some environemnt that isn't shared by other sic people, and is only sporadically sterilized.

Yep, I have no idea how to actualy do that. There are all kinds of issues, but I'd guess that you can solve nearly all of them with tech.

Like a surgery center? They do have those.

I worked at a hospital for awhile, and one of the things I found interesting, though, is that the departments balance each other out. For example, our hospital did obstetrics more as a service to the community, since other hospitals were much further, but they always lost money on it. So maybe the reason we don't see surgery centers or things like that as often is that medical institutions are more stable providing a broader range of services.

I feel a lot less silly now for avoiding medical treatment unless absolutely necessary all my life.

The difficulty is avoiding treatment and not diagnostics. If your method of avoiding treatment is never going to the doctor, ie, never being diagnosed, you don't really know when your problems are life-threatening.

So this would be a bad time to start talking about rates of community acquisition of MRSA and C. difficile, wouldn't it?