The M.R.S.A. bacteria(methicillin resistant staphylococcus), is resistant to most antibiotics. This strain has been identified for fifty years. Reported cases have grown significantly since 1990, in the order of ten times in five years according to a Health Canada report in 2001, which suggests that if preventative measures aren’t rapidly instituted, the situation could become uncontrollable in a few years. Regrettably these well-known measures for more than twenty years were largely ignored with the result that there was a significant increase in all nosocomial infections, C. difficile, MRSA and others. There have been at least 7000 C. Difficile victims in Quebec in 2003-2004 and more than 1200 fatalities. MRSA is identified in more than 5000 cases with a mortality rate between 20% - 50% depending on the individual circumstances. Every month in Quebec there are between 350 and 600 new MRSA cases and the bacterium is becoming increasingly resistant to treatment. It is known that at least 30% of these infections are avoidable.
How does one become infected ?
MRSA is found in between 25-30% of normal healthy individuals (You and me). These people could contract an infection in the event of any invasive medical procedure: where the skin is breached, during a surgical procedure such as the insertion of a catheter or the replacement of a knee or hip. Contamination in a hospital could come from an infected or a host patient (host is a carrier but not necessarily infected) in a shared room, or by way of the hands of a health care professional.
Consequences of infection.
Like any infection condition, nosocomial infections can be bacterial, viral, fungal, or even parasitic. There are various types of nosocomial infections affecting various different sites. An approximate list in order of occurrence, with CDC 1996 data on frequency is:
- Urinary tract infections (34% in 1996)
- Surgical site infections (17%)
- Respiratory infections especially nosocomial pneumonia (13%)
- Blood infections/bacteremia (14%)
- Skin (especially burns)
- Gastrointestinal tract infections
- Central nervous system infections.
Evidently the consequences can be extremely serious, the mortality rate climbing to 50%. Some of these infections take months to cure, where in some cases there is no cure. ( see the broadcast Enjeux (March 1st,2005) Descent into Hell (Radio Canada)
The economic impact is staggering, boosting the costs of illness or surgery anywhere from $14,000 to $28,000, depending on the case, and this without taking into account the enormous costs for patients and their families (long term sick leave, job loss and the costs of drugs not covered by Health Insurance) Vancomycin, one of the antibiotics used against MRSA, can cost up to $800 per week and this may be required for several weeks or even months.
The Present situation (Quebec)
Prior to 2001 MRSA was rarely found outside the Greater Montreal area. Today it is to be found throughout the province, and represents some 27% of staphylococcus infections. By comparison in Holland and Denmark this rate is about 0.5%, because in these small countries, with populations comparable to that of Quebec, stringent, country-wide policies for screening, isolation and prevention have been in force since 1990.
Rigorous and consistent application of appropriate practices is the key to successful containment and reduction of patient infections and are basically the same in the prevention of most nosocomial infections.
Screening of all patients at admission.
Isolation-quarantine of all patients at intake.
Rigorous hand washing regime prior to each and every patient contact for all health care professionals and hospital staff.
Rigorous hand washing regime before and after visits for all hospital visitors.
Wearing gloves and gowns for both hospital personnel and visitors.
Scrupulous daily disinfection of all patient facilities. Rooms, beds, furnishings, bathrooms and supplies.
“Dedicated” staffing for infectious patients.
Mayo Clinic - USA
APIC -Association for Professional in Infection Control- USA «The danger of MRSA»
|< Prev||Next >|