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MRSA cases on rise throughout state

Barb Erber of Harvard cleans and disinfects a room Wednesday at the Mercy Harvard Care Center. Mercy Health System disinfects its rooms to help combat MRSA and super germs.
Barb Erber of Harvard cleans and disinfects a room Wednesday at the Mercy Harvard Care Center. Mercy Health System disinfects its rooms to help combat MRSA and super germs.

In 2000, Jeanine Thomas of Willowbrook fell and broke her ankle. To repair the joint, doctors operated.

After two days in the hospital, she went home but was experiencing terrible pain. Thomas called her surgeon and returned to the hospital. When doctors removed her cast, they found that her incisions had turned black.

Three days later, it was determined that she had been infected with MRSA, or Methicillin-resistant Staphylococcus Aureus. After almost three weeks in the hospital, Thomas finally stabilized.

“I went into septic shock and multiple organ failure,” Thomas said. “It went through my blood stream. They were going to amputate my leg because it was so bad. They cut all the way down to the bone, but luckily it stabilized.”

Thomas, who declined to say in which hospital she was infected, later started the MRSA Survivors Network and proposed hospital screening legislation, which was signed into law by former Gov. Rod Blagojevich in 2007.

Public Act 095-0312 requires that all Illinois hospitals develop and implement a MRSA control program and report aggregate data on MRSA infection rates to the Department of Public Health.

Even though infection rates are reported, Thomas said that because they are presented to the public in aggregate form, it is not consumer-friendly. She said that she had appealed to the department to report individual hospital infection rates.

“They have to report the rates for the [intensive care unit patients] and whatever other at-risk patients they’re screening; they have to make that available,” Thomas said. “We haven’t seen that.”

Melaney Arnold, a spokeswoman for the Illinois Department of Health, said that the department collected hospital infection rates in an aggregate manner.

“We’re looking into doing that eventually,” Arnold said of presenting individual hospital infection rates.

Bridget Pachay, infection prevention coordinator at Mercy Harvard Hospital, said that MRSA was a type of staph bacteria that was resistant to certain antibiotics. Most MRSA infections are skin infections, she said, but the more serious MRSA infections happen most frequently among patients in health care settings.

“Staph is a pretty normal, common bacteria that lives on our skin,” Pachay said. “It usually doesn’t cause people any harm unless something would happen when they could get a cut, have surgery, or become immuno-compromised.”

Pachay said the hospital screened patients admitted to the intensive care unit to see whether they had MRSA. Health care professionals take a cotton swab sample from the patient’s nose and send it off to the lab. Results return after a few hours, and if someone is colonized, meaning they have tested positive, they are placed in isolation.

Pachay said that the Mercy hospital, which performed 114 cultures in 2010, had 20 positive MRSA cultures, none of which were hospital-acquired.

Karen Van Buren, lead infection preventionist for Centegra Health System, said that they reported 850 positive MRSA cultures in 2010 – which accounted for both health care-acquired and community-acquired MRSA – out of 3,700 cultures.

Of 4,912 cultures done at Advocate Good Shepherd Hospital in Barrington between Aug. 1, 2010, and Feb. 15, 2011, 18 were positive – all community-acquired, said Jo Sheehan, manager of infection control for Advocate Good Shepherd.

Dr. Bob Tiballi, an infectious disease specialist on staff at Advocate Good Shepherd Hospital in Barrington, said that the reason for the 2007 legislation was because of an escalated number of cases in recent years.

“Fifteen years ago, a hospital might only see one or two cases of MRSA in a month,” Tiballi said. “Most recently, because of the use of broadly-used antibiotics, MRSA has become prevalent inside and outside the hospital. Now 50 percent of all staph infections we see are caused by MRSA when this used to be far short of 1 percent 15 years ago.”

MRSA is a reportable disease in Illinois, but not in the United States. Arnold said that in 2009 there were 19,565 MRSA infections in the state. This number reflects both community-acquired and health care-acquired MRSA infections. According to earlier data from the Department of Public Health, in 2002 there were 6,841 cases of MRSA diagnosed by Illinois hospitals.

According to the CDC, MRSA skin infections commonly occur at sites of visible skin trauma, such as cuts and abrasions, and areas of the body covered by hair and often first look like spider bites or bumps that are red and swollen.

Health care-acquired infections are more severe and can cause complications such as bloodstream infections, surgical site infections, pneumonia and death.

Dr. Irfan Hafiz, an infectious disease specialist with Centegra Health System, said that while he had seen more cases in the community, he was not seeing more transmission in the hospital. He assigns blame for the increase in MRSA cases mainly to the overuse of antibiotics, and said that as a result of this overuse, bacteria have learned to adapt.

“What happens is that, for example, when a child goes to the doctor with an upper-respiratory illness, which are often viral, they are put on antibiotics unnecessarily,” Hafiz said. “Taking antibiotics one time isn’t going to cause this, but after taking them repeatedly, the sensitive germs are all gone and they’re replaced by drug-resistant germs.”

Despite the rise in cases, area doctors said that if people take responsible precautions and health care institutions follow the appropriate steps, MRSA is not something to fear.

“MRSA is not hard to eliminate or kill,” Pachay said. “The key thing is good hand hygiene. Even if you are colonized or you live with someone who’s colonized, you’re probably not going to contract a MRSA infection unless you have an open wound or you’re immuno-compromised.”

•••

In 2007, former governor Rod Blagojevich signed into law two different pieces of legislation to promote better efforts to prevent MRSA infections in Illinois hospitals. Despite the legislation, cases of MRSA reported by hospitals throughout the state are on the rise.

Area doctors listed these tips for preventing the spread of MRSA infection:

• Practice thorough hand-washing habits.
• Avoid overuse of antibiotics.
• Maintain a healthy immune system by making healthy eating and lifestyle choices.
• Practice good external skin care.
• Wash bath towels between each use.
• Avoid the use of bath sponges.
• Bath brushes and loofahs should be run in the dishwasher to be sterilized.

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