Posted on 01/01/2009 10:11:16 PM PST by blueplum
"The strain of a once-innocuous staph infection that has become invulnerable to first-line antibiotics kills more people each year than the AIDS virus and in most cases is contracted in hospitals.
...SB 1058 will require hospitals to report infections such as MRSA to the Department of Health Services, effective Jan. 1."
(Excerpt) Read more at sacbee.com ...
I am a hospitalist physician.
I wear street clothes to work and back home
I would wager if you swab every hospital workers nasal mucose that over 1/2 of us are carriers of MRSA
What would you practically do? Put every hospital worker on broad spectrum antibiotics that would only increase resistance?
MRSA is around and has been for years. It does not scare me nearly as much as most resistant bacterial infections (pseudomonas, vre, etc)
We see nearly as many cases of MRSA acquired in the community now as we do in the hospital. The bacteria is in the community at large and I do not see a practical way of stopping it. But we can run up huge tabs in attempting to control a horse that is long out of the barn.
containment is not possible. We see nearly as many MRSA infections acquired in the community as in the hospital. The bug has been around for years. It is not one of the things that keeps me awake at night as a hospital worker. I suspect I have been colonized for years, and probably the rest of my immediate family as well
This is not a bug that causes a lot of problems for people with normal immune systems. Now talk about pseudomonas, VRE, or acinetobacter and I might agree with you. THese are much rarer, more virulent, and MAY have some utility in trying to contain.
Clothing, linens, gowns, dishes, environmental surfaces, etc....have NOT been implicated as vectors for MRSA.
Hand washing, folks....it's simple and effective.
FRegards,
There are likely many more sources than we have suspected and not all of them naturally occurring either as there is some justifiable speculation about weaponizations. The CDC is really looking at this and there is also a special division within the USDA working to detect other sources.
Mom MD: What is a “hospitalist physician”? Are you an Infectious Disease MD? Just asking.
democratsaremyenemy: Better check your sources.
cherry: >>”.....please point to one case where anybody contracted MRSA from someone’s uniform....”<<
From the link below:
“The study found about 85 percent of all invasive MRSA infections were associated with health care settings, of which two-thirds surfaced in the community among people who were hospitalized, underwent a medical procedure or resided in a long-term care facility within the previous year. In contrast, about 15 percent of reported infections were considered to be community-associated, which means that the infection occurred in people without documented health care risk factors.”
“About 1 out every 12 deaths during hospitalization with a serious MRSA disease occurs in persons admitted for community-associated MRSA infection, the remaining 11 of every 12 deaths are associated with MRSA related to healthcare exposures;..”
“Do not share personal items. Avoid sharing personal items such as towels, washcloths, razors, CLOTHING, or UNIFORMS that may have had contact with the infected wound or bandage. Wash sheets, towels, and clothes that become soiled with water and laundry detergent. Drying clothes in a hot dryer, rather than air-drying, also helps kill bacteria in CLOTHES.”
From your link...Universal precaution's are standard.
But, that being said....plain ol' simple hand washing...remains the NUMBER ONE preventive procedure to stop the spread of MRSA.
And I will repeat that clothing, linens, gowns, equipment...are not generally implicated as a vector in the spread of MRSA.
fwiw-
FYI...
http://www.iht.com/articles/2008/09/23/healthscience/23well.php
While the role of clothing in the spread of infection hasn’t been well studied, some hospitals in Denmark and Europe have adopted wide-ranging infection-control practices that include provisions for the clothing that health care workers wear both in and out of the hospital. Workers of both sexes must change into hospital-provided scrubs when they arrive at work and even wear sanitized plastic shoes, also provided by the hospital. At the end of the day, they change back into their street clothes to go home.
http://usawellnesscme.com/mrsa/course/preventing.html
I think we know that with the environment as a potential source, if you bring scrubs home from your emergency department visit, this does run the risk of bringing this organism into your home. I would strongly encourage physicians not to wear their work clothes home if they’re concerned about community-associated MRSA. It would be ideal for them to change into scrubs, wear the scrubs, and then have the scrubs laundered.
http://www.infectioncontroltoday.com/hotnews/dangerous-hospital-scrubs.html
The Committee to Reduce Infection Deaths (RID) announces it is calling on all hospitals in the U.S. to provide clean uniforms or scrubs for their personnel and to bar medical workers from wearing uniforms outside of hospital buildings.
“You see them everywhere: nurses, doctors and medical technicians in scrubs or white coats,” says Betsy McCaughey, PhD, chairman of RID. “They shop in them, take buses and trains in them, go to restaurants in them, and wear them home. What you can’t see on these garments are the bacteria that could kill you.”
http://allnurses.com/nicu-nursing-forum/mrsa-protocol-310547.html
When we spot someone in scrubs we are on them before they can touch a thing. We ask them where they are coming from in scrubs. If they came from working on a “dirty floor,” we make them gown and glove, and tell them that they should not visit after work without showering and changing clothes, or they should come before work. Most of the time, people are cooperative and understand why we are making them do all that.
http://goliath.ecnext.com/coms2/gi_0199-7174838/Home-laundering-of-surgical-scrub.html
Sixty-five percent of nurses caring for patients with methicillin-resistant Staphylococcus aureus (MRSA) had contaminated uniforms.
http://www.audiology.org/news/Pages/20080929a.aspx
How can someone (in particular, a licensed health-care professional) change out of their street clothes, put on clean scrubs to enter the OR (or clean room, or lab etc) and then wear the same scrubs out of the OR? Don’t they get it? Is it somehow okay to wear scrubs with microscopic OR goo tagging along throughout the day (”Hey, thanks for wearing those OR clothes to the lunch room - sit here next to me”). Worse still — what about when these same licensed health-care professionals leave the cafeteria, go to the locker room, take off their lab coats and then go back into the OR. What are they thinking? Don’t even try to tell me that’s okay! I’ve seen it hundreds of times and I’ll bet many of you have, too. Sometimes it’s a surgeon, sometimes an audiologist, maybe a nurse, maybe a tech. I’ve seen them all do it, really. And truth be told, I did it, too, many years ago. But we’re smarter now.
http://www.salisbury.nhs.uk/media/pressreleases/scrubs.asp
Nursing staff will wear a clean pair of tunic and trouser style scrubs at the start of each shift, with used sets washed daily at very high temperatures using an industrial process in the Trust’s on-site laundry. Staff will not be able to wear scrubs outside the hospital.
http://www.vpico.com/articlemanager/printerfriendly.aspx?article=220444
Stamford Hospital in Connecticut recently banned wearing of scrubs outside the hospital, given the surge in C. diff. cases, a new superbug threat. MonroeHospital opened its doors two years ago and has had no hospital-acquired infections. The extraordinary success of this Indiana hospital is due in part to hospital laundering of scrubs and prohibiting personnel from wearing scrubs beyond the building.
Like nearly anything...I can find and post many articles, studies, and whatnot...that supports my position.
I will stand with many Physicians, and other health care professionals that I know..and say once again..that THE best preventative to spreading infectious DZ's is "hand washing"
Period.
Disclaimer: Opinions posted on Free Republic are those of the individual posters and do not necessarily represent the opinion of Free Republic or its management. All materials posted herein are protected by copyright law and the exemption for fair use of copyrighted works.