For about a year, I worked toward safer and more effective MRSA prevention in Maine Hospitals. I proposed the very things that I learned of from MRSA prevention experts (Infectious disease doctors who have written recommendations, nurses, microbiologists, advocates and activists) , and hospitals who have practiced Active Detection and Isolation to stop the MRSA growth in their facilities. But, Maine hospitals and infection control practitioners obstructed ADI. It was even a struggle to get them to comply with the new State Law to screen high risk populations. The entire process was contentious and arduous. It was also controlled by people who do not do direct care of infected patients.
Not all of the populations who are at risk for acquiring MRSA when hospitalized were included in the current MRSA “prevalence test” in Maine. The populations that are included are 1) patients who have been in the hospital or nursing home within the past 6 months, including transfer patients, 2) all ICU patients 3) Prisoners, 4) dialysis patients.
The ones who were not included are 1) Immunocompromised patients, ie patients with diabetes, Cancer, HIV/AIDS, and those on medications that render them immunocompromised, 2) Patients who are facing surgery involving implants, ie. Orthopedic joint replacement surgery, Cardiac valve replacement, Neurosurgical shunt placement, 3) Patients who are IV drug users, 4) Patients with open infectious appearing wounds. Other populations are more susceptible to MRSA too, including the elderly, who are more prone to Hospital Acquired MRSA, and the young who are more prone to Community Acquired MRSA (those in contact sports, day care centers, close living quarters like dormatories). All of the patients in this paragraph are known to be at increased risk for getting MRSA, yet, Maine hospitals and their representatives fought against screening for them.
So, since only a part of the effective approach of ADI (and that part was severely diminished) was accepted as law in Maine, what can you do to protect yourself from MRSA if you must go into a Maine hospital?
Ask your doctor for a simple nasal and/or wound culture. This simple cheap test may save your life. If you know you are scheduled for a hospital admission, do this test about 10 days prior to admission. This allows time for the culture to come back and for decolonization treatment if necessary. After the culture is done, be sure to follow up on results because not all lab results are reported back in a timely way. This simple test, and treatment if necessary could save you from unnecessary suffering and/or death.
Why won’t your hospital just do this for you without you having to request it? That is such an excellent question. Actually, during this current prevalence test, some hospitals are screening all new admissions. But, for the ones who are not, I have my own theories about why they just won’t do it without a request, none of them flattering. The problem of MRSA and many other hospital acquired infections has been brewing and growing in our hospitals for years. The multidrug resistant infections have come front and center and increased mostly for the past 10 to 15 years. There has been a complacency and helplessness attached to these infections and not a whole lot was done until very recently to STOP THE INFECTIONS. I believe that the reason hospitals do not want to screen you for MRSA unless forced to by law or after a hospital has had a significant or deadly outbreak of the infections, is they are afraid of liability.
They do not want to be liable for proper rooming of patients to avoid spread of disease. They want to continue to room colonized or infected patients with other patients, and not tell either one of their infection status. This way they can fill beds, wash hands, and hope for the best…..meaning…perhaps the infection won’t spread. But, if it does, they can tell the patient that they probably brought the infection into the hospital with them. Without a screening culture, I guess they could actually say that and get away with it. With a negative screening, will it would be less easy to blame the patient for his own infection. This sounds negative and cruel, but I have spoken with enough victims to know that these things do happen, and they happen often. I do not believe that hospitals intentionally infect patients, but they do not use all of the necessary steps available to STOP INFECTIONS NOW! And when somebody becomes infected they are not entirely honest about the name of the infection or the origin of it.
So, go get that screening before you are admitted to the hospital. If your admission is planned, get it early enough to have results and treatment if necessary BEFORE your admission. Have family members bring in hand sanitizer for you and for your visitors and bring in disinfecting wipes for frequently touched surfaces. Don’t share things, with your roommate. Be sure anyone who touches you does so with clean hands. Nobody should have to ask for clean hands, but it is a fact of life. Just ask and don’t be bashful. If you are too ill, have a patient advocate with you to ask and do these things for you.These are some things that keep you in control of your own well being while hospitalized.
And finally, don’t linger. The sooner you go home, the less your risk for infection.