Your mother enters the hospital for knee-replacement surgery. Two weeks later, she's readmitted, but this time, she has to be hooked up to a ventilator because a hospital-acquired infection, resistant to antibiotics, has entered her bloodstream. She could die.

Your best friend has successful cancer surgery. But while recovering, he catches a "superbug" when drug-resistant bacteria enter his body through a urinary catheter. He has high fever and a redness near the incisions. When his lungs shut down, he deteriorates quickly and goes on a ventilator. He spends weeks in the hospital with the cost ballooning.

An estimated 2 million Americans annually get one of a variety of drug-resistant infections, leading to about 90,000 deaths, the federal Centers for Disease Control and Prevention estimate.

Of those afflicted, 87 percent catch the infection at a healthcare facility, the CDC says.

But those are only estimates. Because there is no nationwide or even state-by-state database, nobody knows for sure how many people are infected, where they got infected and which healthcare facilities have the worst infection rates.

"There's a lot of denial among hospital administrations" about hospital infection rates, said a superbug expert, Dr. Jon Lloyd.

Ideally, your mother or your friend could shop around before surgery for hospitals with low infection rates, maybe by visiting a Web site with hospital statistics.

But Texas consumers will have to wait for the vital information.

The Texas Legislature approved a bill last session to create a state Infection Reporting System.

Lawmakers just didn't provide any money for it.

So Texas hospitals are still not required to keep statistics or report them to the state.

The system, which was supposed to launch June 1, would collect data on surgical-site infections, certain bloodstream infections and respiratory infections that often lead to pneumonia. The information would eventually be made public on the Internet.

But officials estimate that they need $1 million to get the system going. Although a committee is talking about the kinds of data hospitals should collect and how they should report it, the program's fate is unknown.

"Might not even have reporting by the end of the year," said Jeff Taylor, manager of infectious disease surveillance at the State Health Services Department.

Sen. Jane Nelson, R-Flower Mound, who sponsored the bill establishing the system, said that in the 2009 session, she will pick up the fight to find funding.

"If I were queen, there would be money in this budget to have that system up and running," she said. "Unfortunately, some members believed that a major agency devoted to public health could implement this legislation with existing resources.

"Once we have a recommendation from the agency on a system to build and we know the actual costs, I will immediately start pressing for funding."

MRSA

Texas lawmakers passed another infections-related bill last year. It creates a one-year pilot program in three urban areas to collect information about one of the best-known infections -- methicillin-resistant Staphylococcus aureus, a superbug that can resist antibiotics.

MRSA causes about 19,000 deaths a year nationwide.

The pilot program begins July 1 in San Antonio, Amarillo and College Station. In 16 months, when the program's final report is released to state lawmakers, Texas will have its first real MRSA stats.

If legislators like the program, it could spread statewide. By my estimate, though, it won't happen until at least July 2011. Lawmakers must first review the pilot program's results.

Important step

Hospital-acquired infections are easily spread among healthcare workers and from patient to patient by hands, equipment and clothing. Severe ones resist regular treatment by antibiotics.

Medical experts say that public reporting is an important step toward lowering infection rates.

"It may make some people really sit up, take notice and take the steps they should be taking to get rid of it," said David Jefferson, environmental health manager at Tarrant County Public Health.

Lisa McGiffert of Consumers Union in Austin runs a national campaign to get states to require infection-rate reporting. The campaign's Web site -- StopHospitalInfections.org -- displays news reports about hospital infections nationwide.

"We know there's a great deal hospitals can do to prevent these infections, but they're not doing them," McGiffert said.

"We believe that publicly reporting each hospital's infection rate will motivate hospitals to take up these techniques, improve the care at their hospital and prevent infections."

'Make a commitment'

The incentive for hospitals to take their infection rate seriously will soon grow stronger. Starting this fall, the federal government won't reimburse hospitals to treat Medicare and Medicaid patients who acquire infections at the hospitals, which will have to pay for their own shortcomings.

"These are all things that should have happened 10 years ago, and it is frustrating that it takes so long," McGiffert said.

"The state needs to make a commitment towards this, and they haven't done it. I don't think it's on the radar of any of the leaders in this state."

The problem, McGiffert and other health experts say, is that the added costs of treating infections strain an already overburdened healthcare system.

Public reporting is the first step, they say, to ending the problem and saving lives.