MRSA Infections Continue to Go Unreported

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In the US - MRSA kills more people than AIDS – about 19,000 a year.

In addition, the bug infects 95,000 people every year - and many more carry it without knowing it.

Those numbers come from a new study published in the Journal of the American Medical Association.

The JAMA study revealed that 85% of MRSA infections are still associated with or picked up at healthcare facilities.

The study has refueled debate over whether hospitals should collect MRSA data and report it publicly.

Lori Nerbonne, a nurse formerly from Sanburnton, became a patient advocate after watching her elderly mother fight for her life after contracting a MRSA infection at a local hospital.

The bug can cause anything from mild skin boils to organ failure or fatal bloodstream infections.
Nerbonne’s mom recovered, but died within a year from a separate illness.
She feels her mom should have been able to find out about the hospital’s infection record.
NERBONNE: “ Consumers are left out of this equation...You can go to Consumer Reports and find out all kinds of information on things you’re buying - but when it comes to healthcare or you’re having surgery - really serious surgery on your body you should have access to accurate data on how hospitals are performing in that area.”

So far, only a few states, not including New Hampshire, list MRSA as a pathogen that should be reported publicly.

In New Hampshire, the legislature created a commission in 2005 to review and analyze hospital medical errors, unexpected adverse outcomes, and near misses.

The New Hampshire Health Care Quality Assurance Commission is made up primarily of hospital representatives.

Stephanie Wolf- Rosenblum, who is vice president of medical affairs at Southern New Hampshire Medical Center, chairs the commission.

She says that the group isn’t charged with a focus on MRSA per se - but that they certainly understand how important it is.

WOLF-ROSENBLUM: “Professionals in state of New Hampshire have their eye on infections as being one of the most important if not the most important adverse outcome for a patient receiving care in one of our facilities. It shows that it is very high on our radar screen and we are very much interested in it.”

Rosenblum’s group has been focusing on some preventable infections.

But she says that decisions on whether to track and report MRSA fall under the purview of the Department of Health and Human Services.

Jose Montero is the state epidemiologist at HHS.

And he says that he just doesn’t have the resources to track MRSA rates at hospitals.

Until those resources come through, he’s working on a pilot project with the New Hampshire Hospital Association to design a preliminary reporting system.

But, he says, initial reports aren’t likely to include MRSA.

MONTERO: “We should be able to provide to the general public a report that shows how infection control is working in hospitals. We shouldn’t have any central line infections in any patients because we know how to prevent those we shouldn’t have any surgical knee infections because we know how to prevent those. We need to be able to show the public where this is happening and where it isn’t and what activities are being taken to reduce to zero those events from happening.”

Montero added that HHS has applied for CDC funding to address drug-resistant pathogens overall.

At this juncture no one can say with confidence whether MRSA infection rates are rising or falling at New Hampshire hospitals.

But if MRSA is added to public reports in the future – at least one infection control specialist will have her data ready.

Linda Caine is the infection control director at Elliot Hospital.

CAINE: “We track MRSA here at Elliot Hospital much like other facilities do. We screen which means all we do is take a swab of a person’s nose. That is just a screen and tells us yes or no if MRSA is present.”

Caine had already been keeping track of patients who had become infected by the bacteria.

But the new screening program captures more data by identifying patients who carry the bug without realizing it.

Most US hospitals don’t screen patients for the bug – and instead rely on healthcare workers to wash hands appropriately and follow other precautions.

But some states have passed laws requiring such screening - and isolation - of patients who present a risk.

Epidemiologist Carlene Muto was one of the first in the country to implement those procedures for MRSA.

She chairs the infection control committee at the University of Pittsburgh Medical Center’s Presbyterian Hospital.

Muto’s known nationally for her work in successfully battling the bacteria.

But even she was surprised by JAMA’s report on how widespread it had become.

MUTO: “The information that they just reported - it’s astonishing is the only word I can think of. The rates of MRSA are higher than the rates of any other organism that we’ve ever collected from a public health standpoint.”

She added that the superbug outnumbers pathogens that cause meningitis, strep pneumonia, and many others that governments have been tracking for centuries.

Pennsylvania was one of the first states to report hospital infection rates publicly – though MRSA hasn’t yet made the list.

Muto says that despite some kinks – public reporting has had a positive impact in Pennsylvania.

MUTO: “I definitely think with time we’ll have better access to patient safety information but for right now I think we’re moving in the right direction because I think what this whole reporting thing did was act as a catalyst to get hospitals to do a better job.”

Muto says that it would be best if the federal government passed legislation requiring screening and reporting.

That way, all states would follow the same procedures.

And she added that it’s not just patients who want to see that infection data.

She says she gets calls from physicians looking for the hospital infection rates when they need surgery --- or when someone from their family does.

For NHPR News, I’m Dianne Finch