Hospital Personnel Potentially Spreading Methicillin Resistant Staphylococcus Aureus (MRSA) Within the Community: A Call for MRSA Testing of Healthcare Workers and Also of Community Facilities

    /24-7PressRelease/ - BURBANK, CA, July 03, 2007 - The recent conference hosted by the Association of Professions in Infection Control (APIC) drew attention to the increasing prevalence of methicillin resistant Staphylococcus aureus (MRSA) among hospitalized patients. While some patients are admitted with, or subsequently develop, active MRSA infections, other patients are simply carrying these bacteria on their skin and/or mucosal regions such as in the nose, mouth and genital areas. These carriers pose a risk to themselves and to other patients for the development of active infections. To help avoid this risk, several patient advocacy groups have called for mandatory MRSA testing of some, if not all, admitted patients. This view is resisted by APIC and by The Society of Hospital Epidemiologists of America (SHEA) largely on the premise that it removes some of the discretionary authority of its members. Beneath the surface, there is also the belief that many hospitals do not really wish to know the MRSA status of patients upon hospital admission because, if negative, it would negate the contention that any subsequent infection was potentially self acquired.

Another topic that was not openly addressed at the conference is why APIC does not recommend universal screening of healthcare personnel. One issue is the potential legal liability if a patient learns that a physician may have been the source of a serious infection. Furthermore, some Sates have reporting requirements that would necessitate the physician taking work leave until the MRSA were cleared. These self-protective attitudes seem foolhardy when one considers the medical risk an MRSA carrying physician poses to him or herself and to other staff, family and community members. Moreover, it is unreasonable to extend a hospital's reluctance for self-testing to nurses, nursing aids, ward personnel and janitorial support staff. Complacency on this issue may also reflect the usual assumption that only sick patients are really at risk for serious MRSA infections. Unlike earlier strains, today's MRSA generally produce a powerful toxin, termed PVL. Upon inadvertant entry of MRSA into even healthy tissues, this toxin can readily overcome the body's defenses leading to an invasive and occasionally flesh-eating disease. Whether out of ignorance or for other reasons, the emphasis is still being placed on the antibiotic resistance of MRSA, rather than on the more recently acquired capacity for toxin production. Carriage of toxic MRSA is also likely to be a determining factor in the severity of the pneumonia that can complicate influenza, including the anticipated bird flu epidemic.

Hospital personnel must be regarded as a potential health threat in bringing MRSA into the community setting. Increasingly, one hears of infections occurring in childcare centers, schools, gymnasiums and other sporting and recreational facilities. Undoubtedly, some of these infections were the result of MRSA spreading from a hospital setting via a healthcare worker. It is disappointing that this issue is not being directly addressed by organizations such as APIC and SHEA. For further information the reader is referred to the "War on Staph" section on the web site www.s3support.com Information at that site is also available on a simple inexpensive MRSA Staph Identification Plate for the public's use in screening environmental areas for MRSA. Additional inquiries can be addressed to [email protected]

Kind regards,
W. John Martin, MD, PhD.
Institute of Progressive Medicine

The Institute of Progressive Medicine, formally the Center for Complex Infectious Diseases, is a non-profit public charity. Its members include experts in infectious diseases, including MRSA. E-mail inquires to [email protected]. Telephone inquiries to 626-616-2868

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