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This is the largest nationally representative study to date of the toll taken by sepsis and pneumonia, two conditions often caused by deadly microbes, including the antibiotic-resistant bacteria MRSA. Such infections can lead to longer hospital stays, serious complications and even death. "In many cases, these conditions could have been avoided with better infection control in hospitals," said Ramanan Laxminarayan, Ph.D., principal investigator for Extending the Cure, a project examining antibiotic resistance based at the Washington, D.C. think-tank Resources for the Future. "Infections that are acquired during the course of a hospital stay cost the United States a staggering amount in terms of lives lost and health care costs," he said. "Hospitals and other health care providers must act now to protect patients from this growing menace." Laxminarayan and his colleagues analyzed 69 million discharge records from hospitals in 40 states and identified two conditions caused by health care-associated infections: sepsis, a potentially lethal systemic response to infection and pneumonia, an infection of the lungs and respiratory tract. The researchers looked at infections that developed after hospitalization. They zeroed in on infections that are often preventable, like a serious bloodstream infection that occurs because of a lapse in sterile technique during surgery, and discovered that the cost of such infections can be quite high: For example, people who developed sepsis after surgery stayed in the hospital 11 days longer and the infections cost an extra $33,000 to treat per person. Even worse, the team found that nearly 20 percent of people who developed sepsis after surgery died as a result of the infection. "That's the tragedy of such cases," said Anup Malani, a study co-author, investigator at Extending the Cure, and professor at the University of Chicago. "In some cases, relatively healthy people check into the hospital for routine surgery. They develop sepsis because of a lapse in infection control—and they can die." The team also looked at pneumonia, an infection that can set in if a disease-causing microbe gets into the lungs—in some cases when a dirty ventilator tube is used. They found that people who developed pneumonia after surgery, which is also thought to be preventable, stayed in the hospital an extra 14 days. Such cases cost an extra $46,000 per person to treat. In 11 percent of the cases, the patient died as a result of the pneumonia infection.

Known as 'polyandry' among scientists, the phenomenon of females having multiple mates is shared across most animal species, from insects to mammals. This study suggests that polyandry reduces the risk of populations becoming extinct because of all-female broods being born. This can sometimes occur as a result of a sex-ratio distortion (SR) chromosome, which results in all of the Y chromosome 'male' sperm being killed before fertilisation. The all-female offspring will carry the SR chromosome, which will be passed on to their sons in turn resulting in more all-female broods. Eventually there will be no males and the population will die out. For this study, the scientists worked with the fruitfly Drosophila pseudoobscura. They gave some populations the opportunity to mate naturally, meaning that the females had multiple partners. The others were restricted to having one mate each. They bred several generations of these populations, so they could see how each fared over time. Over fifteen generations, five of the twelve populations that had been monogamous became extinct as a result of males dying out. The SR chromosome was far less prevalent in the populations in which females had the opportunity to have multiple mates and none of these populations became extinct. The study shows how having multiple mates can suppress the spread of the SR chromosome, making all-female broods a rarity. This is because males that carry the SR chromosome produce only half as many sperm as normal males. When a female mates with multiple males, their sperm will compete to fertilise her eggs. The few sperm produced by males carrying the SR chromosome are out-competed by the sperm from normal males, and the SR chromosome cannot spread.