Deadly Infections in Hospitals
Deadly infections are a serious problem in hospitals. To prevent these infections, hospital workers will typically test patients for the drug-resistant bacteria MRSA and then isolate and treat those that are infected. However, a new study found that the best way to prevent hospital infections doesn't even require prior testing, and that it is better to treat every patient with the germ-killing soap and ointments used to treat those who do test positive for MRSA.
MRSA, Silent and Deadly
MRSA, or methicillin-resistant Staphylococcus aureus, is a bacteria that is highly resistant to a host of drugs commonly used to treat infection. About 1-2% of people carry MRSA in their noses or skin, but have no symptoms of infection until they reach the hospital. Once at the hospital, they become susceptible to having the bacteria enter the bloodstream during invasive procedures or to other patients through health workers' hands.
Largest Study of Its Kind Demonstrates Best Method to Prevent Infections
The study, which is the largest of its kind, looked at nearly 75,000 patients at 74 adult ICUs in 43 hospitals. The protocol, whereby all patients are treated with germ-killing soap and ointments regardless of whether they test positive for MRSA, is known as decolonization. The study found that hospitals where decolonization was utilized reduced all blood stream infections, including those caused by other germs. Overall, deadly infections caused by other germs were reduced by 44%, and the incidence of MRSA-positive patients was reduced by 37%.
MRSA Costs the Healthcare System
The researchers also added that this protocol should be adopted by all hospitals to prevent deadly hospital infections, which cost the healthcare system $20,000 per one infection. The universal treatment approach is relatively inexpensive and yielded dramatic benefits.
recently named in the 2009 edition of Best Lawyer's In America, David Mittleman has been representing seriously injured people since 1985. A partner with Church Wyble PC—a division of Grewal Law PLLC—Mr. Mittleman and his partners focus on medical malpractice, wrongful death, car accidents, slip and falls, nursing home injury, pharmacy/pharmacist negligence and disability claims.
3 Comments
Michael Bennett
There is much about this study that is so far unsaid and that leaves much to be desired: First, the arm of the study that is being celebrated occurred only in ICUs; most hospital-spread MRSA infections occur in other areas of hospitals. Second, the study gives only a passing mention to the problem of chlohexidine (CHG) and muprocin resistance---serious problems that are well-documented in the literature and that would surely result from widespread deployment of such an intervention. And it should be noted that CHG is ineffective against Gram-negative bacteria which are much more prevalent in hospitals than MRSA, which is Gram-negative. Third, even if you ignore the problem of creating resistance, the enormous cost, in both dollars and hospital staff and other resources, of deploying such make it impractical if not altogether impossible.
There is so much bias both in the study design, analysis, and the accompanying editorial that one is left gasping at the lack of scientific integrity involved here. Two examples of this are the disparaging references to the Veteran's Administration hospitals' use of screening, which has actually cut MRSA infection rates more so than in this study, an the reference to a clinical trial also known as the STAR*ICU study. This study had so many problems with it (many more than what is mentioned in the editorial by Edmond, et al, which accompanies this current study), it went unpublished for four years!
So one might ask: who and why was this study ever conducted and why tout it? The answer to these questions, I believe, lies in the background and agenda of the authors of this study. A simple google search will reveal people with long histories of opposition to MRSA control and to using screening in particular. To that end, the subtitle of the editorial is quite revealing, "Case Closed," case meaning the use of Active Detection and Isolation (ADI), or 'screening,' to control MRSA. Ironically, these same folks will promote ADI to control other important hospital-spead pathogens while simultaneously opposing its use to control MRSA, and the like. They summarily dismiss hundreds of studies supporting ADI for control of MRSA and entire countries and regions that have successfully done likewise for decades.
The current culture of public-health leadership and its nihilistic attitude toward hospital-spread disease is what has brought this epidemic upon us. That culture and that thinking must change. We badly need scientists and clinicians who are true to their creed influencing policy. We don't need daily chemical baths and nose ointments that ignore the widespread problem while creating others.
Michael Bennett
President
The Coalition For Patients' Rights
Michael Bennett
Correction to my earlier post, which should have read,
" ...Gram-negative bacteria which are much more prevalent in hospitals than MRSA, which is Gram-positive."
Howard
I feel like the majority of infection can be reduced through "simple" means. However, and this may just be me, it's often easier for people to remember the complicated appose to the simple.
Comments for this article are closed.