SAN JOSE, Calif. -- Consumers Union called on hospitals today to take more aggressive steps to protect patients from Methicillin-resistant Staphylococcus aureus (MRSA) infections in light of a new study showing that the superbug is much more common in hospitals than previous estimates had indicated. The consumer group also urged states to require hospitals to report their infection rates, including how many patients are acquiring MRSA during treatment.
The report released by the Association for Professionals in Infection Control and Epidemiology (APIC) found that MRSA infections are 8.6 times more prevalent than previous estimates and that the antibiotic-resistant bacteria is found in all wards throughout most hospitals. The APIC study is the first nationwide analysis on the prevalence of MRSA in U.S. healthcare facilities. It is based on data collected from more than 1,200 hospitals in all 50 states.
"MRSA is lurking in every U.S. hospital and poses a serious and sometimes deadly health risk to patients who are unwittingly exposed to these superbugs," said Lisa McGiffert, Director of Consumers Union's Stop Hospital Infections Campaign (http://www.StopHospitalInfections.org). "Unfortunately, most hospitals are not doing enough to keep these antibiotic-resistant germs in check. It's time for hospitals to aggressively step up their efforts to protect patients from these preventable infections."
Hospital-acquired infections caused by Staphylococcus aureus, or "staph," are among the most common and the problem is clearly growing. According to the Centers for Disease Control and Prevention (CDC), in 1974, only 2 percent of staph infections in healthcare settings were MRSA; by 1995, the percentage was 22 percent; and by 2004, nearly 63 percent of all staph infections in healthcare settings were MRSA.
MRSA can spread from patient to patient through contact with doctors and nurses with unwashed hands, contaminated gloves, and medical equipment. According to the National Quality Forum, studies show that handwashing compliance rates in hospitals are generally less than 50 percent. A study by the Pennsylvania Health Care Cost Containment Council based on infections reported in that state found that hospital patients with MRSA infections are four times as likely to die, will stay in the hospital two and a half times as long, and are charged three times as much compared to patients without MRSA. In addition to strict hand hygiene, successful strategies recommended by the Society for Healthcare Epidemiology of America (SHEA) for controlling MRSA include "active surveillance" (screening intensive care unit and other high risk patients), isolating and decolonizing MRSA carriers, using gowns, gloves, and masks when treating
them to prevent its spread to other patients, and routine decontamination of patient rooms and operating rooms. See: http://www.shea-online.org/Assets/files/position_papers/SHEA_MRSA_VRE.p
Screening for MRSA is an effective prevention practice because an estimated 20 percent to 30 percent of the population are carriers of staph. They are normally healthy and asymptomatic, although they may experience minor skin infections. Many are colonized with MRSA and if they enter the hospital and the bacteria are spread to other patients, it can cause serious infections.
"We know how to control MRSA, but most U.S. hospitals are not consistently following these successful infection control practices," said McGiffert. "Hospitals need to make a commitment and invest the resources necessary to protect patients from MRSA. In the long run, that will save money and lives."
The survey found that less than half (45 percent) of hospitals are tracking infections throughout the hospital -- the rest are focusing only on intensive care, surgical, or high-risk nursery patients. Further, only 28 percent reported performing active surveillance cultures for MRSA to identify patients who are colonized with MRSA.
Many hospitals in northern Europe have used these strategies to control MRSA for decades. A number of hospitals in the U.S. following this bundle of infection control strategies have documented impressive results. A pilot program at the VA Pittsburgh Healthcare System in Pennsylvania in 2001 has reduced infections in the hospital's surgical unit by 70 percent. Likewise, the University of Pittsburgh Medical Center has reduced MRSA in its intensive care units by 90 percent using this approach and similar results have been documented at the University of Virginia Health System and Evanston Northwestern Healthcare in Illinois.
Consumers Union supports proposals debated in a number of states that would require hospitals to screen certain patients for MRSA and take special precautions with those colonized with the bacteria to prevent its spread. This year, Minnesota became the first state to mandate active surveillance. The New Jersey state legislature just passed legislation that would require such screening, but it has not yet been signed by the governor.
"Screening high risk patients for MRSA is a critical part of an effective strategy to prevent the spread of this deadly super bug," said McGiffert. "But states also should require hospitals to report their patient infection rates, including MRSA infections. The public deserves to know which hospitals are taking this problem seriously and which are not."
Over the past four years, 17 states around the country have adopted laws requiring hospitals to report their patient infection rates. So far, Florida, Missouri, Pennsylvania, and Vermont have produced public reports on their state hospitals' infection rates. More information about these reports can be found at:
Source: Consumers Union