MRSA Symptoms

The UK government is ramping up measures to fight MRSA by screening more and more patients before they are admitted to hospital for planned procedures. MRSA is prevalent in the community and is particularly dangerous if allowed to spread within a hospital environment where people with weakened immune systems are even more vulnerable.

Swabs are taken about two weeks before patients are due to be admitted, and if MRSA is found they are offered a five-day course of nasal ointment or other antiseptic treatment.

Although surgery is not normally delayed by such screening and subsequent treatment for MRSA, if the surgery is “highly invasive” the treatment may take longer. Highly invasive surgey includes procedures such as hip replacements.

According to statistics from the NHS, more than 1,400 MRSA tests were carried out last month and Buckinghamshire Hospitals NHS Trust plan to screen a total of 12,000 people this year.

Dr Jean O’Driscoll, trust director of infection prevention and control, said:

Generally speaking the presence of MRSA on a person’s skin is nothing to worry about.

But when invasive procedures like surgery are carried out this increases the risk of harmless MRSA, present on many people’s skin, passing into the bloodstream and giving rise to MRSA bacteraemia infection, which can be serious.

Low-risk patients are exempt from screening for eye, dental, mouth and minor skin procedures. In contrast, some emergency patients are screened within 12 hours of admission if they are high risk, the trust said. The high risk group includes people who have previously had MRSA, are in intensive care or have recently been in hospital or a nursing or residential home.

Superbug Test Now Available in Europe

A test for detecting the superbug MRSA is now available in the European Union. Improved MRSA screening for methicillin-resistant Staphylococcus aureus (MRSA) should result with the introduction of this new test. The international drug developer Roche has claimed that the new test will help to prevent and control infections.

Hospital To Screen Patients For MRSA

Screening for MRSA will be offered to patients in East Surrey before planned operations, to try to combat the spread of the superbug. Swabs will be taken from patients’ noses before the operation to check for MRSA at East Surrey Hospital Redwood Elective Centre and Crawley Hospital.

Zero Tolerance Battle With Superbug

At the Chesterfield Royal Hospital, hospital matrons have launched a MRSA screening programme for all patients undergoing pre-booked surgical procedures in an attempt to reduce the risk of infection.

‘High risk’ patients have always been screened for MRSA at the Chesterfield Royal Hospital. However, now the pre-admissions clinic is checking everyone admitted for an elective (pre-booked) procedure. This is one more component part in the struggle to combat MRSA and should not be viewed in isolation.

The screening system is part of a nationwide initiative brought in by the Department of Health and supports the hospitals programme of infection control, which includes a hand hygiene and cleaning regime.

If a patient is carrying MRSA they can be given treatment that will significantly reduce the risk of infection. As an infection, MRSA causes boils, infected wounds, abscesses and infections of the chest, bloodstream and urine and, ultimately, can be a killer.

A swab will be taken from the patient’s nostrils or groin and sent off to Microbiology for testing. If it returns positive, they will be given treatments – an antibiotic nose cream and skin wash – to use at home for five days before their procedure.

As a result of the Chesterfield Royal Hospitals proactive approach it is one of the top performers in the country for MRSA rates.

Patients ‘Swabbed’ For MRSA

At Burnley General Hospital and Royal Blackburn Hospital all patients booked in for an operation are being “swabbed” for evidence of MRSA in out-patient clinics. Patients found to have MRSA are sent an antiseptic body wash and nasal spray to use for five days before their operation. This should reduce the risk of infection.

The Burnley General and Royal Blackburn Hospitals are aiming to reach the Government’s target of giving every hospital patient the test by 2011.

Handwashing ‘More Effective At Controlling MRSA Than Isolating Patients’

Regular hand washing could be more effective at controlling the spread of the hospital superbug MRSA than isolating infected patients. Dr Peter Wilson from University College Hospital, London, led a study, which examined two ICU wards over the course of 12 months.

Dr Wilson argues that the best way to halt MRSA is to ensure that staff keep their hands clean. This is not to suggest that isolation should not be considered as an option. It does however re-emphasise the importance of hand washing as part of the very core of the strategy to combat MRSA

Keep up to date with MRSA News.

David Fritzgerald used to work as a maintenance man at a North Dallas apartment complex. In 2003 he developed a stomach ulcer that required surgery. After being admitted to RHD Memorial Medical Center in Farmers Branch, however, he contracted MRSA and within a month he was a quadruple amputee.

Linda Turley, Fritzgerald’s attorney, said on behalf of her client

This has been a life changing event. There is nothing about his life that will ever be the same

Turley reports that a mere three days after undergoing surgery on his ulcer, Fitzgerald was feeling unwell. She goes into more detail:

He was coughing up green stuff, and had a high fever, and his chest x-ray was not normal. During the day, he developed sepsis, and then that evening, went into septic shock.

The septic shock caused irreparable damage to his limbs. By the time the infection was diagnosed and treated, gangrene had set in, requiring the removal of both arms below his elbows and both legs below his knees.

Turley maintains that Fritzgerald’s physician, Doctor Meenakshi Prabhakar, did not treat her client with the proper medicine. Just a month after his initial minor surgery, MRSA had infected Fritzgerald’s limbs so badly that he had to undergo major surgery to amputate his legs. Sadly, the ordeal was far from over when Fritzgerald had to undergo surgery for a third time to remove his arms.

Fritzgerald settled out of court with RHD Memorial Hospital for $900,000. Last week, a Dallas County jury awarded Fritzgerald $17.5 million in damages.

Judge Jim Jordan of 160th District Court awarded $9 million for Fitzgerald’s pain, mental anguish and physical impairment, but Texas state law caps non-economic damages at $250,000. This limit was established in 2003 by the Texas Legislature and applied to all medical malpractice cases. Lost earnings and medical costs, however, can be collected for life.

Turley responded

That is unfair. The jury awarded Mr. Fritzgerald the $9 million, and he’s entitled to his award

Fitzgerald, who lives with his brother in East Texas, has had to rely on family members for daily living over the last six years.

He can’t bathe by himself, can’t get out of the house by himself and will need assistance for the rest of his life

Turley said.

Doctor Meenakshi Prabhakar, a Bedford infectious-disease specialist, is appealing the decision with the help of attorney William Chamblee.

Chamblee:

I think it’s erroneous and it’s a travesty. In my opinion, the jury based their verdict on sympathy, and the judge told them not to

Chamblee went on to say that his client administered eight antibiotics to Fitzgerald but not the one drug that would have treated MRSA, methicillin-resistant Staphylococcus aureus.

Chamblee said of Fitzgerald’s infection:

There were no less than seven doctors from seven specialties, all board-certified, who saw this guy over the crucial time period, and nobody knew what it was

Nevertheless, the jury found Prabhaker to be 100 percent responsible for what happened to Fitzgerald, though it agreed the doctor was not guilty of “gross negligence.”

In recent years, MRSA infections have become more common in Texas and throughout the country. Many more are being acquired in community settings, including schools and locker rooms.

Hospital-Acquired MRSA

Recent research in the UK has found that mobile phones could be encouraging the spread of MRSA in hospitals. Mobile phones do not fall within the scope of hygiene restrictions in NHS hospitals and it is estimated that up to a quarter of phones carry infections such as MRSA. This unsettling discovery was made by scientists at Edinburgh hospital.

The use of devices such as mobile phones and PDAs by doctors on wards improves the communication and compilation of patient records – and is on the increase.  This use, however, helps MRSA and other bacteria spread between patients and doctors alike.

Richard Brady, co author of the report that the research produced, said

Our concern is that many individuals may not be aware of the potential of these devices to spread bacteria or how to clean their phones.

Brady is a research fellow at the Medical Research Council’s human genetics unit at the Western General.

The report appeared in the Journal of Hospital Infection and went on to state that the situation

allows the likelihood that healthcare workers touch mobiles during patient care without performing hand hygiene

US researchers in South Carolina have made a startling discovery in their fight against superbugs like MRSA. Their research has found that a compound from a sea sponge was able to reverse antibiotic resistance in several strains of bacteria. Erstwhile resistant strains became once again sensitive to readily available antibiotics

Resensitising Resistant Bacteria To Antibiotics

Peter Moeller of the National Oceanic and Atmospheric Administration’s Hollings Marine Laboratory in Charleston, South Carolina, reported that

We can resensitise these pathogenic bacteria to standard, current-generation antibiotics

Moeller works with researchers at the Medical University of South Carolina and North Carolina State University. His team noticed a sponge thriving in an otherwise dead coral reef and they started asking themselves how the sponge could survive when everything else was dying. The team then endeavoured to isolate the properties that helped the sponge thrive in hostile marine conditions.

The researchers found that pieces of sponge were able to repel bacterial biofilms – a slimy substance bacteria form to help stick to surfaces.

Moeller went on to say

What we found is these (sponge) derivatives actually dispersed existing bacterial biofilms as well as inhibited production of subsequent bacterial biofilms

As 65 to 80% of all human pathogenic infections are based on biofilms, this is a significant discovery.

Moeller’s team tested the substance on some of the toughest pathogens, including MRSA.

Mixing Sea Sponge With Antibiotics

The researchers found that several once-resistant bacteria were sensitive to antibiotics that were mixed with the sponge material. Moeller and his team are now working with a number of medical device companies to incorporate their discovery into the plastic materials used to make devices like stents (used to prop open diseased arteries or in intravenous lines used in critically ill patients).

Moeller envisages a new class of “helper drugs” that restore the potency of antibiotics that had previously lost the war to superbugs.

Overuse And Misuse Of Antibiotics

Overuse and misuse of antibiotics has led to drug resistance in some strains of bacteria, and this has become a serious problem in hospitals worldwide. This problem is highligted by the prevalence of  the superbug MRSA in our hospitals. In the US, infections such as MRSA kill a staggering 19,000 people every year.

Medical malpractice lawsuits over hospital acquired infections that include MRSA are increasing in the US.

In July, a Missouri couple was awarded $2.58 million after the husband contracted a MRSA infection when doctors inserted a pacemaker. As a result of the infection, the patient lost a kidney and a leg and a foot had to be amputated.

Medical-malpractice defense attorney Neal M. Brown said of the threat of hospital-acquired infections, “What we’re dealing with here is a national phenomenon”. Hospitals are “well-aware” of the danger to patients and are taking strong steps to prevent it, added Brown. These steps include the screening of patients for MRSA on admission to the hospital and frequent hand washing by medical and support staff.

Mary Coffey, an attorney at Coffey Nichols in St. Louis, won the $2.58 million verdict on behalf of the 69-year-old Missouri man who contracted MRSA through an IV that was administered in the ambulance following a heart attack. When doctors later inserted a pacemaker, the infection spread. Although the traditional stance maintained by people in the medical community was that hospital acquired infections are a just part of the risk of being in a hospital, she asserts that the rate of patient infection is “close to zero” when health care personnel comply with strict hygiene protocols.

McCaughy, founder and chair of the Committee to Reduce Infection Deaths, a nonprofit patient safety organization in New York says, “Now that the evidence is overwhelming that nearly all infections are preventable, hospitals that don’t follow the proven protocols are inviting lawsuits.”

Read more about increasing MRSA Infection Lawsuits.

UNC Asheville basketball player, Kenny George, has returned to Chicago after spending 3 months in hospital. Kenny developed a MRSA infection in his right foot and consequently had to undergo surgery to amputate part of it.

The basketball player was released from a hospital in Des Moines, Iowa, on 20th November 2008 and is back in Chicago. He hopes to return to school in January to continue working on his degree.

According to Asheville coach Eddie Biedenbach: “To my knowledge, the infection is completely gone”.

You can read more about Kenny George’s recovery after his MRSA infection.

Hospitals in Lincolnshire, UK are fighting infections by screening patients for MRSA on admission. At the moment, Lincolnshire hospitals perform MRSA screenings on patients admitted as emergencies and other groups of patients depending on the procedures to be undertaken. They aim to screen all elective patients for MRSA on admission by March 2009.

The transmission of MRSA and the risk of MRSA infection can be minimised by taking measures to identify MRSA carriers as soon as they enter a hospital. When identified, they are treated immediately.

Screening of patients takes place on or before admission to hospital and patients identified as MRSA carriers start decolonisation procedures involving the use of antibacterial shampoo, body wash and nasal cream.

Senior Infection Control Nurse at ULHT, Charmian Hutson, says “We find that detecting and treating those who are carrying infections as early as possible is an effective way of cutting MRSA rates- and it’s working. In the last year, rates of MRSA in our hospital have been cut by 37%.”