Thursday, October 15, 2009

MRSA In Our Hospitals, Communities And Homes

By Dr. Richard E. Busch III

Most of us have heard about MRSA, and many of us now know of someone who has contracted it: some of us even know of someone who has died. MRSA (Methicillin-resistant Staphylococcus Aureus) is often noted as the "Super-Bug". Actually, MRSA can be many strains of S. aureus bacteria (it is not a virus), and it is resistant to many antibiotics. There is a continued effort to develop more antibiotics, but it is difficult because of its evolving resistance to more and more drugs. MRSA is most likely to be contracted from hospitals (hospital-acquired infection). Some studies show a contamination rate as high as 64%. There have been random studies performed on common surfaces in hospitals, such as doors, walls in the hospital halls, and elevator buttons, and 80 %of the tested surfaces had evidence of MRSA. Many doctors and healthcare professionals are considering this a global plague - projecting over six million cases in 2010 - with a death rate of over 30 %. The major concern is the limited medical options for care and the sources of contamination that are outside of our hospitals.

MRSA was detected around 1945 (correlating with the development of penicillin), and it has become a significant problem in hospitals and nursing homes over the last 40 years. Obviously, many of the patients in these facilities are sick and their immune systems weakened and vulnerable. Those would include anyone who is in a hospital for surgery. MRSA in the early stages was treated by penicillin; however it soon tested resistant to penicillin, as well as many other antibiotics. MRSA cases identified in a healthcare setting are referred to as healthcare-associated MRSA (HA-MRSA).

It would seem to be natural, if MRSA is most likely to be spread by hand-to-hand contact, that it would imperative to have in place mandatory hand-washing procedures and other hygiene processes in hospitals and other healthcare facilities. Since hospitals and healthcare facilities have implemented computer technology, there is an additional risk of transmission increasing by the use of computer keyboards.

Since the mid-to-late 1990's, additional strains were identified as CA-MRSA (community-associated MRSA), and these were different because there were no healthcare settings involved from which to contract MRSA, and there were no risk-factors such as the injured, sick and immune compromised people. As these CA-MRSA infections were studied, it was determined that they were not caused by the healthcare-associated MRSA strain. According to a majority of research, MRSA occurs in our noses, and if it enters the body through injuries and open sores, then there is a possibility of fatal infections. Anyone can carry MRSA and never have a symptom, and it can be transmitted through contact with contaminated objects and surfaces such as keyboards, door knobs, and direct physical contact. Athletes who have sports contact, locker rooms, gyms, military recruits, and prisons are groups and areas where CA-MRSA is found to be more concentrated. The way to avoid contamination is to always use proper hand washing techniques, always bandage cuts and scrapes, and don't share any personal items such as towels and razors.

Headaches, fatigue, fever, swelling, pain and heat around an incision, wound or injury are common symptoms of MRSA. Infections that are more severe are in the joints, bones, surgical incisions, heart, lungs and bloodstream. Many times a bump on the skin will be dismissed as a spider bite. If it doesn't get better in 3-4 days and you have a fever and flu-like symptoms, this could be MRSA.

MRSA can even infect our companion animals, and there is now a risk for our pets when they have surgery at the veterinary clinic. It is not determined if human contamination from pets is a risk for people. There are new strains of MRSA that seem to be crossing the human and animal barrier. Reporting of infections in horses began to increase, and studies are showing that the infection can be passed from horses to humans and vice versa. Five years ago in the Netherlands, and then more recently in Canada, there was a strain of MRSA (ST398) found in pigs. Since then, this strain has been found in the US, in both farmers and pigs. It isn't certain that this strain will cause human problems, and it isn't certain if it will affect our food supply. Should the ST398 be found to infect humans and/or contaminate our food supply, this brings into play and whole new set of problems and "what-ifs".

Most especially for those considering elective surgery for neck and back pain, consider all your options and research nonsurgical procedures. Surgery is not your only option. MRSA contamination is common in hospitals. Screening could be done for MRSA in hospitals, but many do not. If testing proved positive, then patients would have to be placed in isolation, and this would increase the patient's length of stay and the load on the facility by over crowding and under staffing. It is possible then - this can lead to more contact with infected people - serious under staffing which can lead to less hand washing and hygiene.

About the Author: