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Thursday, August 18, 2011

Active surveillance not stopping spread of MRSA

It sometimes seems a stretch that we are gowning, gloving and wearing masks in many patient rooms when the patient is not even diagnosed with a contagious infection.  Yet it is commonly believed this type of "active surveillance is needed to prevent the spread of infections such as MRSA and VRSA.

In case you're not familiar, MRSA is an acronym for methicillin-resistant Staphyloccocus aureus and VRSA for vancomycin-resistant enterococcus.  These are bacterial strains that have developed resistance to methicillin and vancomycin respectively. 

Those infected are usually people who have a weakened immune system, such as a patient who is sick in the intensive care unit (ICU).  In fact, according to MRSA Still Spreading in ICUs, thousands of Americans die from one of these two infections every year.

An attempt to prevent the spread of MRSA is called active surveillance which, as described by the above article, "includes screening patients admitted to ICUs to see if they carry the bacteria adn then implementing barrier precautions that require health care providers to wear gloves and gowns when handling these patients."

It often seems we are wearing all this stuff for no reason.  Yet many times a person is not in isolation and then all of a sudden they are diagnosed with MRSA.  So even while we've been in and out of the room for three days, all of a sudden we have to gown up.

So there are obvious flaws in the system.  It may come soon the day we have to gown up on any patient until MRSA is ruled out.  Or it may be proven that nothing we do prevents the spread of MRSA, in which case barrier precautions would prove futile.

I personally think patients with weakened immune systems infect themselves.  Staphylococcus aureus is a bacteria commonly found in humans.  So it only makes sense if your immune system is weakened you'd be unable to fight off this bug.  A MRSA infection is the end result.

So you can gown up to your hearts content and still not prevent that person from getting it.  Likewise, you also won't spread it if you don't gown up, because we all have the bacteria we are trying not to spread. 

That's my opinion anyway.  Much of what we do in the healthcare industry is based on minimal research and feel good strategies.  If one person thinks it feels good to do it we do it even if the science doesn't prove it's needed. 



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