HEALTH CARE TRENDS

Hospitals try to curb spiraling staph strain

By Steve Palisin - The Sun News

Staff at area hospitals are washing their hands more and taking other measures to fight the spread of a growing strain of staph infection that is resistant to antibiotics.

Dr. John Charles, medical director at Grand Strand Regional Medical Center in Myrtle Beach, called the methicillin-resistant staphylococcus aureus bacteria a common staph infection that has built a resistance to most antibiotics, including penicillin.

MRSA infections accounted for 2 percent of staph infections in 1974, and then grew to 22 percent in 1995 and 63 percent in 2004, data from the federal Centers for Disease Control and Prevention show.

Shelly Diaz, a CDC spokeswoman, said 126,000 Americans a year are hospitalized with MRSA, and the CDC has stepped up surveillance among hospitals. The higher MRSA incidence rate could reflect patients' misuse of antibiotics, she said, as well as improper hand hygiene in hospitals.

Charles said MRSA has evolved in the past 10 years from a problem seen primarily in health care settings to one also affecting such community activities and institutions as school sports teams, nursing homes and day-care centers.

Charles stressed many people might have come into contact, or colonized, with MRSA, but that doesn't mean an infection has been contracted. That's where the extra attention on staffwide hand hygiene, testing incoming patients deemed to carry a high risk for it, and wearing gowns, gloves and masks come into play to curb the circulation of MRSA.

Kathleen Paranada, a doctor in Myrtle Beach with the Charleston-based Lowcountry Infectious Diseases clinic, said an increase in MRSA presence started in the 1990s, but most clinical cases seen are skin problems instead of life-threatening illnesses.

'Gel in, gel out'

Amy Myers, spokeswoman for Brunswick Community Hospital in Supply. N.C., said the request to "gel in, gel out" with hand-sanitizer dispensers applies to anyone going in or out of a patient's room.

A hand-hygiene committee formed last year at Brunswick, with representatives from every hospital department, continues to brainstorm ways to improve and monitor infection control, Myers said.

Julie Rajotte, spokeswoman for Conway Medical Center, said, "MRSA has been on our radar screen for a while. ... Anyone can be a carrier."

She said managing the 160-bed hospital includes a multiple-component "bundles" approach to curb transmission of MRSA, such as constantly observing staff hand hygiene procedures and watching ventilators and respirators as infection sources.

Mary Lynne Magnus, infection control coordinator at Waccamaw Community Hospital in Murrells Inlet, said visitors might not understand why they're asked to wear a paper mask and gown and latex gloves, as staff do, in the room of a patient with higher vulnerability for a staph infection.

Such extra covering, Magnus said, helps cut down on carrying MRSA elsewhere in the 111-bed hospital, part of Georgetown Hospital System.

Celeste Bondurant-Bell, spokeswoman for Loris Community Hospital, said hand washing remains a never-ending campaign among its 105 beds, extending to all employees and the public in their family lives.

"It's a simple everyday methodology of keeping the germs at bay," Bondurant-Bell said.

Decals on mirrors

Myers said decals on washroom mirrors in Brunswick hospital, with its 60 beds, carry catchy slogans such as "Come clean, wash up" or "Send germs where they belong."

Magnus recounted other sayings on mirrors at Waccamaw: "Friction rubs out germs," the first letters of which form an acronym for the frog pictured alongside; "Live long and prosper: Clean your hands"; and "Don't get caught germy handed."

"We try to change them around so people don't start to ignore them over time," Magnus said.

Winona McLamb, a registered nurse epidemiologist, oversees health and education, including infection control, at Grand Strand Regional, which has 219 beds.

She said nasal swabs are taken to screen for MRSA cultures in incoming patients assessed with higher risk, such as those undergoing back or open-heart surgery or joint replacement, nursing home residents and individuals with intravenous needs.

Charles said he remembers 10 years ago, when one or two patients a month in the emergency department would have MRSA infection, while McLamb said she recently had counted five cases in a week.

When a patient is identified as a carrier or infected with MRSA, contact precautions include having gowns and gloves hanging on the door, McLamb said, to streamline safety for doctors, who often are in a hurry going room to room.

McLamb said her 19-year-old daughter recovered from MRSA three years ago, when she played on a volleyball team.

Charles said a high school official contacted him in 2005 after two wrestling team members picked up MRSA, so in an environment that includes contact among competitors and touching mats, extra awareness matters.

Myers said at health fairs, Brunswick Hospital's booth welcomes the public to place their hands under a glow-germ machine, a black light that shows where individuals miss spots with soap, such as under fingernails.

"Sometimes we think we're doing enough when we're really not," Myers said.

People are more likely to get a staph infection through:

Skin-to-skin contact with someone who has a staph infection

Contact with infected items and surfaces

Openings in their skin such as cuts or scrapes

Crowded living conditions

Poor hygiene

Steps to prevent spreading a staph infection include:

Washing hands often or using an alcohol-based hand sanitizer

Keeping cuts and scrapes clean and covering them with bandages

Not touching other people's cuts or bandages

Not sharing personal items such as towels or razors

Source: www.cdc.gov/ncidod/dhqp/ar-mrsa.html

Full text of article at   http://www.myrtlebeachonline.com/news/local/story/128137.html