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Jan 09 2008

MRSA: Patients Ignored, Left to Die

(Find an update to this post: MRSA, Victimization and Shooting the Messenger)

(And a further update, posted 8 months later:  MRSA:  Patient Ignored, Left to Die — Redux)

In the past two days, I have heard three stories, all related to MRSA and other hospital acquired staph infections, and all relating to heinous — even (in my not-so-humble-opinion) criminal acts on the parts of healthcare providers or politicos.

One story came from a colleague who visited a woman in the hospital. The woman contracted an infection after surgery almost a year ago. She is still in the hospital, on life support, not because of the surgery, but because the infection has just consumed her.

But she is the better story — she is, at least, being treated.

The second story came from a woman I’ll call Maxine. Maxine had surgery last fall, and noticed spots as soon as she got home. Her husband then contracted the infection, and then her son. Her husband was diagnosed with MRSA and given an antibiotic which, of course, did nothing for him. Now NONE of the three can find anyone willing to give them a test for MRSA — because, she tells me, in her state, if they are diagnosed with one of these superbug infections, then that doctor must, by law, treat them. No doctor wants them as patients. She has reached out to me asking what can be done.

The third story is probably at the root of the other two, regardless of the fact that it comes from somewhere else. A man named Jeff thought he might have picked up an infection while at his gym. He went to the emergency room where they began checking him — with no gloves on. When he asked the doctor to wash his hands (you go, Jeff!), the doctor looked at him like he was crazy. The doctor laughed! then told him “that stuff about infections has all been blown out of proportion.” Jeff was given an antibiotic which has done nothing (more than two months later) — but wonders, too, what about the next patient that doctor treated?

And let’s not forget the federal government! It’s has come up with its own unique way of killing off its citizens. At least this is a place we can take action… link to learn more.

Is there some deep, dark conspiracy to make sure these infections continue to kill people? Why is it that providers are, on the one hand, pretending they aren’t dangerous — but on the other hand, they are making sure patients don’t get the treatment they need?

I really just don’t get this one…. and except for harping on the hand-washing advice for my readers, I just don’t know what else we patients can do.

………………………………………………….

(Find an update to this post: MRSA, Victimization and Shooting the Messenger)

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18 comments

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  1. Dr Kadiyali M Srivatsa

    One of the best ways to get rid of a patient in the hospital is to have a urinary catheter installed. Almost half of all infections acquired at hospitals are in the urinary tract, and most are linked to catheters. This I call as “Modern day euthanasia”. Urinary catheters are often inserted in very sick or elderly patient and are not the most common practical procedure when compared to intravenous cannulae. One in every eight patient entering hospital is said to have an intravenous cannula inserted. The incidence of significant local or bloodstream infection associated with peripheral venous cannula is said to be higher than initially estimated. Enormous number of intravenous cannulae currently used in clinical practice may result in an increasing number of intravenous cannula related complications such as phlebitis, thrombosis and bacteraemia. Ported cannulae banned in USA as this is associated with higher incidence of infection but in UK they love it.

    The number of both community acquired and hospital acquired staphylococcal infection has increased in the past 20 years. This trend parallels the increased use of intravascular devices. Doctors have published papers pointing out intravascular device as a major contributor for spreading Staphylococcal infections, yet the headlines in news paper seem to talk about urinary catheters. I have personally warned the cannula & catheter manufacturers’ way back in 1989 but they have turned a blind eye towards this and are talking about needlestick injury.

    I feel sad we are in this situation when no doctor on earth can do anything but pray the patient lives. Healthcare is expensive, who will be ready to pay for an infection introduced to a patient in the hospital. NHS failed to compensate patients and is now planning to fine hospitals. I can see doctors refusing to carry out practical procedures, canceling or postponing operations if the patient is found to be colonized with MRSA. Insurance companies will not be able to cope and government will soon be bankrupt. We better prepare ourselves to hear and see more stories like this in the media.

  2. Jeff Weber

    I am a manager in the hospital and I find both the original article and first comment to be incomplete, inaccurate, and misleading. We have 3-5 antibiotic options to treat MRSA and I have never seen MRSA used as an excuse to not treat somebody, cancel a procedure, etc. This is an every day thing in hospitals that does require different antibiotics but does not result in the things described above. As for urinary catheters and IV catheters – major breakthroughs are occurring in ways to prevent IV catheter infections, and it really doesn’t have much to do with the device themselves, but rather it has to do with precautions about placing it, caring for it, how long its in, etc. And they wouldn’t use the catheters if they weren’t medically necessary.

    Like many blogs, the truth is hard to find here, and the allegations are off base.

  3. Robert Johnson

    I agree with Mr. Weber in that the article and the first reply and not only erroneous, but dangerous.

    I work as a family nurse practitioner in a busy Level I Trauma Center. We see at least five to six cases of MRSA infections a day. These sites are generally incised and drained, packed with gauze, the patient placed on antibiotics pending a culture and sensitivity, and asked to return in 48 hours for a recheck. The packing is removed in 48 hours and the culture is checked to make sure the patient is on a medication that the bacteria involved (usually MRSA) is sensitive to.

    Emergency rooms do not turn away patients, and we treat each patient the same….with the same courtesy and concern as any other patient. We even go out of our way to prescribe medications that are on the Walmart and Target 4 dollar list. The two meds considered most effective against MRSA are on these cheap med lists.

    I would urge you to contact medical professionals when writing articles like this in order to get the best information you can and to avoid misleading readers who already suspect that the healthcare system simply exists to take their money for little service in return.

    Thank you.

  4. Perrin

    Trisha, there are two kinds of MRSA. They are probably related but are distinctly different, and it is important to know which one you are talking about.

    One is the hospital-acquired variety. The other is community-associated, which is what Jeff more than likely had. CA-MRSA typically presents as a skin infection and is rarely serious. Although it’s resistant to methicillin, it generally responds to a number of other cheap antibiotics. It is not the “superbug” that it’s made out to be – so yes, indeed, the ER doctor was more or less correct (although perhaps not diplomatic) when he said it has been blown out of proportion.

    You ask what the public can do. Hygiene, hygiene, hygiene. Do not share towels at the gym. Towel off the exercise equipment before you use it. Wash your gym clothing on a regular basis. If a family member has recently been in the hospital, do not share sheets, towels, pillows, etc. Launder bedding, clothing and towels frequently. If you have a cut or lesion, keep it covered with gauze or a bandage. And for heaven’s sake don’t touch it or allow other people to touch it.

    Maxine’s family and Jeff might have been spared their misery if they had used some common-sense precautions.

    I find it hard to believe no one will treat Maxine’s family. I find it hard to believe that the woman in your first anecdote would remain hospitalized on life support for an entire year. I’m wondering if we (and you) are really hearing the full story here. A little less credulity might be in order.

  5. Trisha Torrey

    Thanks to each of you for posting.

    Perrin — yes — I am fully aware of the two kinds of MRSA and have written about them before. http://patients.about.com/od/atthehospital/a/hais.htm By all means, hygiene will help — and the public needs to be aware (“harping on the handwashing”) but for the doctor to laugh and tell Jeff it was blown out of proportion — on the heels of media about young people who had died? Jeff was taking the precautions he needed to take — and the doctor was not. The doctor was supposedly the professional. The situation was not handled by the doctor well.

    Mr. Webber and Dr. Johnson — if you could let me know where you are located, I would be happy to ask Maxine to contact you. She is frustrated beyond words and I report only what she has told me. The fact is that even if her story is skewed by her perceptions, they are still her perceptions and not only is she not being treated, she is being shunned. If you have a solution for her, she would like to hear it first, and I would like to hear it right behind her. Even her insurance company told her she might have to go out of state to get the diagnosis and treatment she and her family need.

    What I know is that some hospitals have become more diligent and insist on the precautions necessary to prevent MRSA and other staph infections from spreading, although in some cases, they will still spread. What I also know is that too many hospitals don’t. Your infection-stopping practices may work well in your facilities, but those precautions are all but ignored in others. You absolutely know this to be the case yourselves. And if you don’t, you just aren’t paying attention.

    You can dog on me all you want, but the fact is that my mother in law was a victim of a hospital acquired infection, and two other friends died after being infected with MRSA, all three within the past year.

    If I can prevent bad practice on the part of professionals from killing one more person, I will do so.

    Creating awareness goes a long way.

    Trisha

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