Mycollegue, Lori Nerbonne RN, and fellow Patient Safety activist wrote this excellent synopsis about MRSA after her recent research. I found it to be very organized and very well done, so asked if I could share it here on my webpage.
1. Community Acquired and Healthcare Acquired are two different genetic strains
2. CA MRSA is defined by the fact that it is a MRSA in someone who HAS NOT been exposed to a healthcare setting recently.
3. HA MRSA is defined by the fact that you were recently or currently exposed to a healthcare setting . It is not showing up in many patients until they get home from the hospital (they acquired it in the hospital) but this doesn’t make it ‘CA-MRSA’…it is still HA-MRSA that is now out in the community.
4. CA-MRSA is largely treatable if recognized in time—not so with HA MRSA; much harder to treat
5. You can have CA-MRSA when you go into the hospital and then get HA-MRSA, which can make you very sick
6. Co-infections are causing serious illness in death
7. When you have large volumes of people bringing CA-MRSA or HA-MRSA into the hospital as carriers, you have a real problem and vice versa…when they are going home with it (and not being told which is often the case). It’s like water pollution—it’s all being dumped into the same reservoir and colonizing many people
8. It takes a commitment from hospitals and nursing home on a geographic level (in the same community or region/state) to have the greatest impact on reduction strategies because of this ‘dumping’ scenario I described above.
9. Screening is an obvious aid in reducing MRSA because it identifies who is carrying it into facilities and who is still colonized before they go home. It provides the crucial piece of information that is needed to first identify the host (the basis of surveillance in any contagious disease) so they can then be treated before they infect others either directly or via healthcare worker vectors.
10. Hospital/Facility politics is a big reason why there isn’t screening/ADI: Surgeons don’t want to be “told what to do”, hospitals don’t want to invest in extra staff and supplies that would be necessary, and they don’t want to implicate themselves/their facility if a patient is negative on admission and then positive after admission.
11. We have CA and HA MRSA in hospitals (and many other bugs)…but the real ‘take home’ from this is not that “people are bringing it in”…..it’s that hospitals are failing to identify, isolate, and treat those who are bringing it in, thereby putting more and more patients and healthcare workers at risk of harm or death. CA-MRSA can become virulent in sick patients. Hospitals are filled with sick patients, so CA-MRSA can be deadly once it’s inside the four walls of these facilities; especially if patients get co-infections with HA-MRSA or other bugs (Klabsiella, etc)
