I my previous post, I mentioned that humans carry MRSA two ways, colonization and actual infection with the accompanying symptoms, according to what part of the body it affects.
So, why is it important to screen hospital incoming patients for MRSA?
When we are admitted to the hospital, we have no control over who we are roomed with, how well the housekeepers clean, if the staff washes their hands, or many other safety factors. We can stay alert or ask a friend to and keep on top of those things, but if somebody is roomed with us who has MRSA in their nose or somewhere else on their body, we can’t control that. We are forced into living with and sharing facilities with a stranger, not knowing what they are in the hospital for unless we ask them ourselves. I know of two people who found out their roommates had MRSA and it was only a short time later that they had it too. This is just plain unacceptable.
I live with the suspicion that my father was roomed with a patient with MRSA. 3 of his roommates had respiratory infections, all of them with chronic lung problems and at least one of them came from a nursing home. They all predeceased Dad. ALL of them were at high risk for MRSA, but NO SCREENING was done at his hospital and so they do not detect MRSA except when they do what is called “CLINICAL” cultures. Patients are often 4 or 6 or 10 days into their infections before the difinitive diagnosis of MRSA is made and that diagnosis is made with a CLINICAL culture. Then it may be several days (or never) before anybody discloses to the patient that they have it. During that time, no special precautions are taken and the germ is spread with wild abandon. It gets onto the doctors clothing and hands, onto the nurses scrubs, ….it gets carried to the nurses station and onto the computers, off it goes to the Physical Therapy room and into Xray, to the MRI machine and onto the lab techs box she carries, and around and around it goes. No wonder there is inadequate control over MRSA in Maine hospitals.
Screening on admission, of high risk patients, will alert the hospital, the caregivers and the patient that they are carrying MRSA. This may be just colonization, but that is significant in and of itself. It means they have no signs of infection, but the germ is growing in thier nose, or a body crease, or open sore or on their skin. And they can spread it around.
Large numbers of colonized patients are admitted to hospitals every day that are not detected. This is both a risk to those patients and to the other patients they are roomed with. We can’t continue to keep our heads in the sad about colonized patients. Both CDC and SHEA, the so called experts of disease control, state that colonized patients as well as infected patients need to be isolated and contact precautions used. That means a separate room and handwashing, gloves, gowns and masks (as needed) on or between every patient contact. Yet, it is impossible to abide by that recommendation. Why? Because without screening, we will not know if they are colonized.
Patients who are colonized with MRSA are at a significant increased risk of getting a full fledged infection. They are also reservoirs of MRSA for spread to other patients, Healthcare workers and the environment. Without knowing who is colonized and enacting the proper contact precautions, MRSA gets spread all over the place and there is no way to control it.
We screen, we isolate and we protect…both the colonized patient and the other patients. No MRSA prevention program will work without high risk screening /Active Detection and Isolation.