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MRSA – super bug or superstar?

MRSA – super bug or superstar?

(OnTarget. Vol 4, issue 6 2005)

MRSA, or methicillin resistant Staphylococcus aureusto give it its full name, has never been so popular!

Working in the devices industry we may forget that we also have a part to play in controlling this evasive disease.

A typical day could mean accessing clinical areas in as many as five hospitals. This has to increase the risk.

This article outlines some of the issues you and your company may wish to consider. This antibiotic resistant bacteria is the superstar, lets say Brad Pitt, of the microbiology world, hitting the tabloid headlines most weeks!

But what really is the problem with MRSA? Do we know? Do we know how it might affect us as patients, staff or visitors to healthcare settings, and do we know what we can do about it?

Well, the actual problem is more complicated than headlines that tell us ‘MRSA, flesh eating virus, ate my father’s leg’! Headlines like this raise awareness of the fact that there is a problem related to infections acquired while receiving healthcare, however, they are often inaccurate, frightening to would-be patients, and often don’t help to address the true problem.

What is the problem with MRSA ?

The problem with hospital acquired, or healthcare associated infection (HAI) as it is more commonly known, has developed over a number of years, thought to be due to a number of factors. MRSA is thought to be one of the most common bacteria associated with HAI. One factor for this includes the fact that since antibiotics were invented, the bacteria that the antibiotics are used to fight against have been clever and have continued to evolve to protect themselves from certain antibiotics, making some infections harder to treat. This is the case with MRSA. In addition, changing healthcare has led many to believe that the standards within hospitals in particular have fallen, and that this may have contributed to the increased spread of microorganisms such as MRSA, that lead to potentially avoidable infections in susceptible patients.

Some of the problems specifically related to MRSA are reported at a national level, namely MRSA bacteraemia rates. Such blood infections are often the most serious of all infections. In addition, local areas will often report further, more detailed information that they have gathered in order to act upon problem areas, for example those patients who have contracted MRSA infection in surgical wounds.

As Staphylococcus aureusis a bacteria then lives on skin, or can live in dust made up of shedded skin scales, or can cause infection in for example wounds, it is easy to recognise that the most common way in which it might spread is through hand contact. This contact may be directly with a patient or with the healthcare environment where MRSA might be living after being shed from contaminated sites.

The risks associated with contact with the healthcare environment can be considered:

 Those vulnerable patients, who have compromised health and require intense care, often including the insertion of devices to provide essential treatment, are unfortunately at risk of acquiring infection.

 Those staff providing such care will also be at risk, of picking up, in particular, bacteria, which may never affect them as healthy individuals, but may be a factor in cross infection to vulnerable patients.

 Other staff and visitors may be at risk, either to picking bacteria or to being a factor in cross infection. However, this risk should be lower if contact with patients and the healthcare environment is lower.

All of these risks of course depend on how we interact with healthcare environments and the measures that we take to protect ourselves and others.

What can we do to control HAI?

Many recent national and local initiatives have focussed on improving standards to try to ensure all HAI are prevented as far as possible. Recently the focus has been upon hand hygiene and ensuring that all within healthcare settings decontaminate their hands appropriately. The use of alcohol hand solution products, such as gels, has been highlighted in addition to hand washing, to ensure that those who have contact with patients and the healthcare environment can decontaminate their hands at all the appropriate times, especially when staff have many other pressures of work.

Therefore, one of the key messages in the control of MRSA, and other bacteria that can cause HAI, is to adopt simple, fundamental measures that will protect patients and others. If such measures are applied, then we can at least be confident that we have played our part in the fight against MRSA and other HAI.

Training on such measures is crucial, to ensure all within healthcare environments are aware of the actions they can take, and training programmes are available and delivered in many different ways. For visitors, posters are often used to alert them to the problems and actions to be taken. For healthcare workers and other associated staff training programmes delivered by specialists are often given on induction to the workplace, with further updates, at least annually, ensuring awareness is maintained.

Can you guarantee that you and your company are taking this subject seriously and what mechanisms and standards of practice have you put in place to stop the finger being pointed at you.

In the meantime, lets hope it’s not you or one of your family that hit the headlines next along side the MRSA superstar!

Claire Kilpatrick
Nurse Consultant Infection Control
Health Protection Scotland


For further information on Hospital Access please contact Carol Allan on:
carol@hospital-access.com
www.hospital-access.com

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