Tuesday, November 14, 2006

MRSA: The Hospital Scourge

I just read Glenn Reynolds post about MRSA versus AIDs testing in hospitals. He references this from the New York Times:

WHAT kills more than five times as many Americans as AIDS? Hospital infections, which account for an estimated 100,000 deaths every year.

Yet the Centers for Disease Control and Prevention, which are calling for voluntary blood testing of all patients to stem the spread of AIDS, have chosen not to recommend a test that is essential to stop the spread of another killer sweeping through our nation’s hospitals: M.R.S.A., or methicillin-resistant Staphylococcus aureus. The C.D.C. guidelines to prevent hospital infections, released last month, conspicuously omit universal testing of patients for M.R.S.A.

That’s unfortunate. Research shows that the only way to prevent M.R.S.A. infections is to identify which patients bring the bacteria into the hospital. The M.R.S.A. test costs no more than the H.I.V. test and is less invasive, a simple nasal or skin swab.

Staph bacteria are the most prevalent infection-causing germs in most hospitals, and increasingly these infections cannot be cured with ordinary antibiotics. Sixty percent of staph infections are now drug resistant (that is, M.R.S.A.), up from 2 percent in 1974.

The article then goes on to describe how MRSA is spread. Who's fault is it ? Why, it's the patients who bring it to the hospital. So the solution, according to this would be to test all the patients.

My solution? Test all the doctors, nurses and keep everything clean. Test monthly. Let's assume that every patient entering a hospital is MRSA positive. Then what? More antibiotics? The only solution is to make sure the hospital is clean, and make sure the doctors and nurses actually follow sanitary procedures, etc.

MRSA is a bi-product of anti-biotic overuse. This started with doctors, family physicians and the hospital culture of "do something" coupled with super bugs being created where there was a high concentration of antibiotic use. Resistant strains of bacteria don't grow in your house, unless you overuse antibiotics, too.

Patients looking for an easy way out, turn to antibiotics too often. They don't make their physicians take cultures to make sure the infection is bacterial (I've had to ask for this every time antibiotics were prescribed). They want their kid to be spared. They want to be spared. This has a cyclical affect of weakening the immune system, killing all bacteria that protects the body both good and bad and setting the host up for another infection once the antibiotic course is finished. Stronger and stronger antibiotics are prescribed. The patient gets weaker and weaker.

The solution is rather simple: suffer. Drink water. Rest. Eat well. Let the fever work. Build your immune system. Oh, and avoid Hospitals unless you're going to die anyway.


Marcia said...

Staffing becomes a huge issue here. Staff need to have the time to be cautious and keep infection contained.

Anonymous said...

There's something similar to MRSA out here in Los Angeles, unofficially called "Skid Row Staph" because it first surfaced among the homeless of Los Angeles' Skid Row. A nasty staphylcoccal skin infection that's immune to most all antibiotics.

The name is completely unofficial. Officially, Skid Row Staph doesn't exist as the name is offensive to the homeless community.

kman said...

Here is another issue where transparency in the medical comunity would help reward good behaviour. If people knew success / failure rates of hospitals, emergency care centers, doctors, etc. they could make educated decisions on where they wanted to spend their medical dollars. Hospitals that went the extra mile to keep down infections would be rewarded for their extra effort by charging more for their services and having educated consumers willing to pay for them.