From the AP – yeah, I know.
Testing all new hospital patients for a dangerous staph “superbug” could help wipe out a germ that likely kills more Americans than AIDS, consumer advocates say and early evidence suggests.
Yet few U.S. hospitals do it, and many fight efforts to require it. Jeanine Thomas, who nearly died from the drug-resistant staph but, says the reason is simple: “Doctors don’t want to be told what to do.”
The Chicago suburbanite’s personal crusade led Illinois this year to become the first state to order testing of all high-risk hospital patients and isolation of those who carry the staph germ called MRSA.
Powerful doctor groups fought against it. The testing and isolation of patients would be too costly, they said. Many other germs plague hospitals that also require attention. Experts said a more proven approach would focus on better hand washing by hospital staff – a simple measure tough to enforce.
Yet, Thomas prevailed. Similar measures passed this year in Pennsylvania and New Jersey. And Thomas’ national crusade to make hospitals test for MRSA and report their infection rates gained steam after a Virgina teenager’s death from the germ and a government report estimated it causes dangerous infections that sicken more than 90,000 Americans each year and kill nearly 19,000.
Suddenly the little-known germ with the cumbersome name, methicillin-resistant Staphylococcus aureus, is getting lots of attention.
People in health care settings, like hospitals and nursing homes, are most at risk for MRSA infections. Doctors and nurses who treat staph-infected patients and then don’t carefully wash up can spread the germ to other patients. Germ-contaminated medical devices used on people having dialysis or medical procedures also can spread staph. Older patients and blacks are most at risk, according to the recent report by government researchers.
MRSA, pronounced Muhr-suh, has been around for decades and in recent years has spread to schools, prisons and crowded housing projects. Even healthy people can carry it on their skin. It make look like a pimple or spider bite that doesn’t heal, but can turn deadly if it enters the bloodstream or morphs into a flesh-eating wound.
Yet, many infection control experts oppose required testing for it in hospitals.
Many note that MRSA is just one of dozens of risky germs that often infect people in hospitals – particularity those with weakened immune systems or open wounds.
But Lisa McGiffert doesn’t buy it. The director of the Consumer’s Union’s campaign to stop hospital infections calls that “an argument of distraction.”
“Certainly there are other superbugs and they should be tackling those, too,” said McGiffert. “To eradicate hospital-acquired infections is going to take a comprehensive effort” that should include testing hospital patients, she said.
About 1.7 million Americans each year develop infections from various germs while hospitalized and almost 100,000 of them die, according to the U.S. Centers for Disease Control and Prevention .
MRSA accounts for only about 10 percent of these infections. Other worrisome bugs include C-difficile (an intestinal infection), vancomycin-resistant Enterococcus (linked with intestinal, skin and blood infections), and drug-resistant Acinetobacter (which can cause pneumonia, skin and blood infections); none of them accounts for more than 10 percent of hospital infections.
MRSA infections have hogged attention, partly because they’re on the rise. And, acknowledges the CDC’s Dr. John Jernigan, “MRSA likely accounts for a disproportionate amount of illness and death” because of its strength and resistance to mainline antibiotics.
CDC recommendations for fighting drug-resistant bugs list MRSA testing as an option. However, the agency says it’s unclear whether that works better than other measures. Those include judicious use of antibiotics, hand washing, and wearing gloves, gowns and other protective gear.
“We don’t think (testing is) a silver bullet to that problem,” Jernigan said.
The Joint Commission, an independent, nonprofit group that sets standards for the nation’s hospitals, doesn’t have specific rules on how to prevent MRSA.
The commission’s Dr. Robert Wise said the organization wants to see evidence that MRSA testing and other measures work. He said the commission hopes to have an answer early next year and then will then decide whether to adopt new standards.
Perhaps the commission will review an experiment done in Pittsburgh. There, the Veterans Affairs hospital tested new patients for staph, using a nose swab. They isolated those who had the germ, and annual infection rates fell from about 60 to 18 cases, said Dr. Rajiv Jain.
The staph bug used to cause “occasional” deaths, but no patient has died since 2005 when testing of all patients began, said Jain, who is with the VA’s MRSA prevention program.
In May, the VA began putting a $28 million testing system in place for all 155 hospitals. But it costs about $32,000 to treat one hospitalized MRSA patient, so “if you reduce the infections by 50 percent, you more than recuperate the cost,” Jain said.
Denmark, Iceland, Norway, and the Netherlands have reduced their MRSA rates and all test high-risk patients. In the Netherlands, that means testing foreign patients.
Opponents of mandatory testing point out that these small countries all had low rates of the germ to begin with. Hospitals in larger, more diverse nations like Britain, for example, have long had problems with MRSA.
And testing may not make sense for hospitals that treat few high-risk patients or where other bugs are prevalent, opponents say.
“The best approach is not to have state legislators dictating how hospitals go about fighting infections, said Dr. Don Goldmann, of the Institute of Healthcare Improvement, a nonprofit advocacy group.
At the University of Chicago Medical Center, doctors have been focusing on C-difficle bacteria, which can cause severe intestinal illness.
With Illinois’ new law requiring MRSA testing, “We’re having to shift gears and haven’t been able to devote what we’d hoped on these other pressing problems,” said Dr. Stephen Weber, the hospital epidemiologist.
At Chicago’s Rush University Medical Center, lab supplies alone for the testing will likely cost about $80,000, said Stacy Pur, Rush’s chief nurse epidemiologist for infection control.
“It’s very labor-intensive and we would really much rather focus our efforts on infection control” measures proven to work, including better hand washing by hospital staff, she said.
But Thomas, the MRSA patient-turned-advocate, argues: “You’re never going to control this with hand hygiene, because you’re never going to get 100 percent compliance.”
Thomas had never heard of MRSA until she slipped on ice seven years ago and broke her left ankle. That landed her in a Chicago hospital, where she got the infection.
Two days after being sent home, she developed throbbing pain in her left leg. She went to the emergency room, where doctors removed her splint and found the ankle hugely swollen, black and draining pus. She was admitted and given antibiotics, but within a week the infection spread inside her body: her lungs, kidneys and other vital organs shut down.
Hospitalized for three weeks and bedridden for six months, she recovered but her ankle joint was destroyed. She formed a support group and began lobbying for the new law.
Now Thomas is working with advocates in several other states.
“We have a wave happening,” she said.
And if Illinois hospitals don’t comply, she may push to enact testing of all – not just high-risk – hospital patients.
That has been done since 2005 at three Chicago hospitals in the Evanston Northwestern Healthcare system. There, the MRSA infection rate has dropped 60 percent, said the system’s Dr. Lance Peterson.
And at the VA hospital in Pittsburgh, Jain reported an added bonus. The rates of other hospital-acquired infections also fell after MRSA testing began.
Why? The testing may have caused hospital workers to pay more attention to hand washing and other prevention efforts, he said.
MorganLighter
January 14,2008
My husband spent 15 months in 3 different hospitals and I don’t know how many “rehabs”. Apparently isolation and sanitary protocols are some sort of a mystery to these”medical professionals”. Even the docs are too germy to touch their patients.
An ICU nurse, ignoring all isolation protocols was heard to say “F them all, I hope they all get it” I hope she got it.
Somerset Hospital, Somerville NJ was the most disgusting of all facilities we were in.
So, if washing hands is too much trouble (never mind gowns and gloves, and God Forbid a mask) I wish they would all get another job.
My husband contracted every hospital borne infection several times, and all anyone could say is “Well, you know, that’s what happens”
What happens is people die.
Lourraine Stamets lourrainestamets@yahoo.com
Lourraine,
It just makes me sick too hear stories, such as the one you told. We have friends and family who have gone through much the same thing – and all because the medical professionals think they are ‘gods’.
Our public health system (what public health system) is in tatters and the AMA is above reproach. We’re allowing these charlatans to continue to practice medicine, and, rarely, when they do get admonished, it’s not more than having them stand in the corner for an hour or write on the blackboard, “I will not kill anyone for the rest of this week’. BAH!
Thanks for commenting and I hope your husband is well.
All the best.
Dear Morgan,
Thank you for responding, however, my husband’s suffering ended on March 15, 2006. Mine continues.
I have spent the last almost 2 years trying to avenge everybody’s suffering. I can’t get an attorney as my husband isn’t apparently worth enough money.
My particular complaints have to do more with nursing care, our docs. mostly were ok, which is the only reason I continued his care at Somerset Hospital.
I cannot understand the level of mis or mal treatment that is an every day occurance, what is wrong with these people???
Hi Morgan – thank you for your words of comfort. I was sort of surprised to see this post on your site – the hospital my dad was in is supposedly one of the best in NJ (RWJ) and what we saw in the ICU was the most disgusting behavior.
We felt so helpless and frustrated when we saw the room unclean, trash wasn’t being emptied out on a daily basis, one of the nurses we spotted in my dad’s ICU room wore gloves as she got ready to take the blood but just before that she touched the trash can lid to throw something in it and we couldn’t resist pointing it out to her and she obviously got mad, another nurse picked up a pillow from the floor and put it on my dad’s bed – and at my pointing it to her she blasted she was not answerable to the family, she is there to treat the patients – well of course, my dad was on ventilator – and sedated!
I dont have the words to describe how disheartening it was to see so many not following aseptic techniques. I am tempted to get in touch with Thomas and support her in this cause.
Hi Yourself!
Isn’t it amazing that the medical profession feels like they are above the rest of us – acting like we are ignorant fools and they are ‘untouchable’.
Your story (and stories of others) just shows how inept and thoughtless our hospitals and their staffs don’t seem to give a rat’s ass about the patients nor the families.
Not only are thousands of Americans seeking medical care in foreign countries because it’s less expensive, but they are also getting excellent care while in the off shore facilities.
John, my father in law, went to Bay Med Hospital, Bay City, MI, February 2007, as he wasn’t feeling too well and they diagnosed it as pneumonia. He was hospitalized and the lack of care he got was insane. Thank God, Cindy’s (my wife) family all lives in Michigan and were able to intervene on John’s behalf – who is just NOW GETTING BETTER! A whole year of giving him this and that, running tests that have nothing to do with the problem – took him off medication that he’s been taking for the past 35 years, mistakenly thought he was a Alzheimer’s patient and gave him the wrong meds – which sent him into a delusional state- and on and on and on.
I’m telling you this not to minimize your father’s passing, but to let you know that the improper/careless/needless health care in the country has gone to hell in a hand basket.
If you’d like to get your blood boiling more than it is now, I have a list of books you can read – probably be able to check them out from your local library – so, if you’re interested just let me know.
Truly wishing you the best, as I said before, and that the healing process for all of you is swift.
Peace.
OMG, what a mess. It is truly a shame for him to have to go through this for so long. I’m glad he is doing better now.
You know, in my dad’s case also, they never really ‘confirmed’ that he had staph infection. They kept switching their diagnosis from viral pneumonia to bacterial pneumonia to lung toxicity from Amiodarone etc but they would slip in here and there that they were really not sure what happened to him after such a short stay in the hospital, especially when he had walked into the ER the first day and overall he was healthy, had walked a mile and a half earlier that morning at home.
and then they said the antibiotics they gave him were too strong for his system and killed all the good bacteria which caused him to develop fungemia – now didn’t they know this beforehand?
no two doctors talk to each other – each doctor came and prescribed something different. No one questions them. You are right, they act like Gods and treat us like we don’t understand anything and are below them. We had a few close family friends who are doctors but in different hospitals, even they had a difficulty dealing with this hospital staff… they are damn territorial and the ego play was so obvious and sickening.
At one point they had met with us and told us that he had improved but then within next hour or so they started saying his condition had worsened. We feel we would never know if someone gave him a wrong med and he had a reaction or a similar blunder took place.
thank you Morgan. I’d definitely be reading more on the subject but right now is not the good time I guess – it’s been really difficult to come to terms with everything that happened in the last month and a half! but send me the list at my email please and I’ll get to them eventually.
Believe me it helps to hear we are not alone in this mess, the system going to hell is exactly what’s happening in US.
I thank you from the bottom of my heart for talking to me and giving comfort Morgan.
best regards
Pearl,
Thank you for your caring and concern regarding Cindy’s (my wife) dad. Actually, he is doing better, now that he’s off all the crap the doctors were prescribing. His appetite has returned and he’s getting his strength back.
I will be putting together the list of books that you should find enlightening – some of them will make you want to scream – and will send it to your email address.
Again, hoping that you and your family can find some closure and just know that your father is in a better place.
Peace.
a useful blog :)
keep blogging ya :x
Pimple – Thanks for the comment. Take care and hope you visit my site soon. Ciao.
The style of writing is quite familiar to me. Did you write guest posts for other bloggers?
Hto to Get Six Pack Fast – I’ve answered this question from you once before.