Experts say the state should require healthcare facilities to publicly disclose such information; "The hospitals are the infection hot spots ... They're not following hygienic procedures. These deaths are preventable, and whatever they're doing is obviously not enough."

When California officials announced this month that they would begin tracking virulent "superbug" infections in gyms, schools and other community settings, they billed it as a major advance in public health. But the plan would capture just a fraction of drug-resistant infections, leaving the vast majority unreported to the state and unknown to the public, according to experts and consumer advocates. Disease-tracking experts say California lags behind at least 15 other states that monitor such infections where they are most likely to occur: in hospitals and other healthcare facilities.

At least five states make infection reports public, so that consumers might be alerted to the institutions with infection-control problems. More than a dozen other states, including Oregon and Washington, have plans to publicly release such data in the near future. The magnitude and cost of healthcare-related infections -- which are largely preventable -- are substantial. According to national estimates, one out of 22 hospital patients gets a drug-resistant infection and 99,000 patients die from them each year. In California hospitals alone, such infections cost the state $3.1 billion annually to treat, according to a recent estimate by the California Department of Health Care Services.

A variety of healthcare and consumer groups are pressuring California to provide more public oversight. The California Nurses Assn. agrees. The union is pushing for public reporting of infections in the state's roughly 6,000 healthcare facilities, arguing that without public oversight, hospitals often cut costs by downsizing nurses and other infection-control staff. "Infection control is about not keeping secrets. You can be a lot more effective if there's disclosure about what's going on," said union lobbyist Donna Gerber. "The more the public knows, the more accountable hospitals are going to be."