Falklands : Chief Medical Officer Reports on MRSA
Submitted by Falkland Islands News Network (Juanita Brock) 21.04.2010 (Article Archived on 05.05.2010)
Healthy People can get MRSA. MRSA skin infections are showing up more frequently in healthy people, with none of the usual risks factors. This type of MRSA - called community-associated MRSA (CA MRSA) - has been reported among athletes, prisoners, and military recruits. Outbreaks have been seen at schools, gyms, day care centres and other places where people are in close proximity.
CHIEF MEDICAL OFFICER REPORTS ON METHICILLIN-RESISTANT STAPHYLOCOCCUS AUREUS (MRSA): CURRENT SITUATION
By Roger Diggle MD
Healthy People can get MRSA. MRSA skin infections are showing up more frequently in healthy people, with none of the usual risks factors. This type of MRSA - called community-associated MRSA (CA MRSA) - has been reported among athletes, prisoners, and military recruits. Outbreaks have been seen at schools, gyms, day care centres and other places where people are in close proximity.
Interestingly, it also looks like MRSA has jumped from humans to household pets, where it can linger without obvious symptoms - and possibly re-infect the pet owners. strains have been found in cats and dogs so far
This strain of the common "staph" bacteria causes infections in different parts of the body - including the skin, lungs, and other areas. MRSA is sometimes called a "superbug" because it is resistant to many antibiotics. Though most MRSA infections aren't serious, some can be life-threatening. One in 100 people carry the bacteria on their bodies, but don't get sick.
People who have recently had surgery or a hospital stay have an increased risk of developing MRSA. It is also seen in older people, those living in nursing homes, and people with weakened immune systems. A chronic medical condition like diabetes, or cancer increases your chances of getting this stubborn infection
Hospitals, where viruses and infections abound, have been singled out as a prime location for contracting MRSA. But hospitals are working to curb the problem. Preventative measures by health care staff include good hand hygiene and wearing gloves.
The KEMH has invested a great deal of time and resources in to making sure the hospital maintains its MRSA free status. We can still say that MRSA is not endemic in our hospital environment. This is largely due to a strict screening program directed by our infection control policy and rigorous routine and deep cleaning procedures. The policy itself is continually reviewed and amended where required allowing for changes in Department of Health strategies and also in-house requirements.
In the last few years we have seen a marked increase in the number of isolated cases of MRSA. In the beginning MRSA was only identified in those patients returning from treatment overseas, however now we have community acquired MRSA and this poses a problem when trying to keep it out of the hospital on a daily basis.
We have put various hand hygiene props in place throughout the hospital and largely these are used by all staff and visitors. However, there are still situations when MRSA can be passed on even with all these precautions. The KEMH has a unique ward setting in that the Elderly Care Unit (ECU) is sat adjacent to the acute care ward and there is only one set of nursing staff to cover both areas. This would not happen anywhere else and as a result the ECU is subjected to regular screening and often MRSA is found in multiple patients. It must be noted that although these patients are residents in the hospital they are elderly as opposed to unwell and as such MRSA is not a significant risk to them.
During a recent MRSA outbreak in the KEMH treatment plans were actioned that reduced the risk of cross over from the elderly residents to the acute ward. Rooms of the affected patients had to be deep cleaned, including bathrooms. In some cases the bacteria was still identified via settle plate analysis and the rooms had to cleaned again. This means that nearly half of the domestic team where tied up with cleaning one area and as such the rest of the hospital cleaning had to be delayed. Plus some of the rooms were then out of bounds until they were deemed clear by the laboratory.
We can now confirm that this outbreak has now been resolved and we continue to have our MRSA free status.
There are various research teams in the UK and around the world working on new techniques and equipment in the continued battle against hospital acquired infections. It goes without saying that we would benefit a great deal from some of these innovations. In particular, The Bioquell decontamination unit. This unit cleans any area that can be sealed using hydrogen peroxide in a fraction of the time it takes a domestic team, with guaranteed results. It also targets bacteria that are difficult or impossible to clear like Clostridium difficile. It can be used in an office with computers on or in a ward with no equipment at all. There is no harmful residue and the room can be used an hour later.
It should be noted that antibiotics that would normally be routinely prescribed no longer work for MRSA (methicillin, amoxicillin, penicillin, oxacillin, and cephalosporins). So the doctor may prescribe tryclindamycin, trimethoprim-sulfamethoxazole, or linezolid. Vancomycin has been effective in treating invasive MRSA, but must be administered intravenously.
If antibiotics are prescribed, it is important to finish all doses - even if your symptoms fade. Stopping early can cause the infection to come back - and can allow the MRSA bacteria to develop resistance against the few antibiotics that still work.
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