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Hospitals Fight MRSA Screening

JEAN REXFORD AND CARRIE SIMON

April 17, 2008

Despite growing documentation that screening of at-risk patients for Methicillin-resistant staphylococcus aureus prevents serious infections, Connecticut hospitals continue to stonewall and fight a sane and sound amendment to Senate Bill 579.

That amendment would require hospitals to submit a plan to the state Department of Public Health on how they will deal with this growing public health problem. The debate over the need for stricter MRSA prevention has been heating up. MRSA, a variant of the common staph bacteria, is responsible for potentially life-threatening infections in surgical wounds, bones and joints, the heart and lungs.

Hospitals continue to say they will deal with the problem and to leave it in their hands. Yet year after year, the rate of infection grows and perhaps, truth be told, their hands are dirty. Year after year, they have had opportunities to plan. What are they waiting for?

In June 2007, the Association for Professionals in Infection Control and Epidemiology released the first nationwide analysis on the prevalence of MRSA in U.S. health care facilities. The study was based on data collected from more 1,200 hospitals in all 50 states. The association found that hospital-acquired MRSA infections are 8.6 times more prevalent than previous estimates.

And yet very few hospitals actually track infections throughout the hospital. Connecticut has begun to count infections caused by intravenous linesin the intensive care unit, but what about the rest of the hospital?

A number of hospitals have begun to do a nasal swab of all patients being admitted to screen for MRSA. Patients who test positive are isolated from other patients and are treated by health care workers who wear disposable gowns, masks and gloves.

This has been so successful that the Veterans Health Administration requires all of its 150 hospitals to follow that protocol. The University of Pittsburgh Medical Center reduced MRSA by 90 percent using this approach. The latest report from Evanston Northwestern Healthcare reported recently that screening all hospital patients for MRSA can sharply reduce hospital-acquired infections.

Screening has been shown to save money. Yet it is profoundly disturbing that we have to argue the business case when lives are at stake. The infection control program at Evanston Northwestern saves the hospital $25,000 in uncompensated medical costs per patient every time a MRSA infection is prevented. A study by the Pennsylvania Health Care Cost Containment Council found that hospital patients with MRSA infections are four times as likely to die, will stay in the hospital 2 1/2 times as long and are charged three times as much compared with patients without MRSA.

Hospital-acquired infections are no longer the hospitals' dirty little secret but a very significant public health problem. We track community MRSA but leave 85 percent of MRSA cases — those in our hospitals — hidden from public view.

Jean Rexford is executive director of the Connecticut Center for Patient Safety. Carrie Simon is a MRSA survivor and chairwoman of the Germ Warfare Committee of the Connecticut Center for Patient Safety.

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