Preventing Transmission of
Dangerous Staph Germs
By Sandra Cooley, RN, CIC
In spring of 2007, the Ithaca Journal ran an Associated Press
article entitled “Dangerous staph germ far more common than thought.” The
article summarized the results of a nationwide study conducted by the
Association of Professionals in Infection Control and Epidemiology (APIC) on
the prevalence of hospital- and health-care-acquired MRSA (methcillin-resistant
staphylococcus aureus) infections.
MRSA is a type of bacteria that
causes “staph” infections that are resistant to certain commonly prescribed
antibiotics. These infections can have serious implications in the hospital
setting, where patients have undergone surgery or have compromised immune
systems due to illness. The study concluded that the national rate for MRSA
infection and colonization is 46 per 1,000 inpatients, which is eight to eleven
times higher than previously estimated.
MRSA infections have been a growing
concern in the health-care setting. In the 1970s, when MRSA was first recorded,
these antibiotic-resistant infections represented two percent of all
hospital-acquired infections (HAI). In 2006, MRSA represented 63 percent of all
HAI, according to the Centers for Disease Control and Prevention (CDC).
Cayuga Medical Center’s current
rates of MRSA are very low and most are cases of colonized, not infected,
patients. Colonized means the bacteria are present but the person is not sick
with an MRSA infection. In 2006, of the 8,037 inpatients treated at Cayuga
Medical Center, we had three cases of hospital-acquired MRSA. This is
significantly lower than the rate of 46 cases per 1,000 inpatients released in
APIC’s nationwide study.
How is Cayuga Medical Center
responding to this growing concern?
Cayuga Medical Center was
designated in 2005 as a benchmark hospital for appropriate antibiotic use in
the category of Community Teaching Hospitals. With the increasing development
of antibiotic-resistant bacteria, the CDC has made the appropriate use of
antibiotics a national priority. Because our doctors use antibiotics
judiciously, we are not contributing to the development of “super-bugs” such as
MRSA. In addition, we will soon be participating in a pilot program of the
National Healthcare Safety Network, which until now has only been open to large
hospitals. By participating in this network, we will collect more data
comparing us to other hospitals in the state and the country.
How do health-care workers at
Cayuga Medical Center prevent MRSA infections?
Cayuga Medical Center has a
vigorous infection control program based on guidelines from the Healthcare
Infection Control and Prevention Advisory Committee (HICPAC) of the CDC. These
guidelines and our infection control program place a very strong emphasis on
hand hygiene using antimicrobial soaps and alcohol hand sanitizers before and
after interacting with each patient. Hand hygiene is critically important in
preventing the transmission of bacteria such as MRSA, which are spread through
direct contact (most commonly human hands).
Every new employee coming to work
at the medical center is required to go through infection control training.
They learn about standard precautions and attend an annual mandatory infection
control refresher course.
What other infection control measures
do medical center employees take?
All of our employees follow “standard
universal precautions,” which means that we deal with every patient as if he or
she has a communicable disease. We do this by using personal protective
equipment, including gloves and gowns, and by following the practices of good
hand hygiene. If a patient is diagnosed with a communicable disease, we limit
contact by using masks and by following isolation precautions. We are also
following APIC recommendations for MRSA transmission and prevention, including
APIC’s MRSA risk assessment and surveillance program.
What happens when a patient is
identified with MRSA?
A patient with MRSA may be either
infected (sick) or colonized. In either scenario, the potential exists to pass
on MRSA through direct contact with other people. When patients are identified
with MRSA, they are put on “contact-isolation precautions.” This means that
anyone entering their rooms dons a gown and gloves, which are discarded
immediately upon leaving the room. In addition, all MRSA patients are flagged
in the computer. If they are readmitted to the medical center at a future date,
they are placed on contact isolation for the duration of their hospital stay.
Does Cayuga Medical Center
participate in the Institute for Healthcare Improvements (IHI) Five Million
Yes, we have been participating in
the IHI campaign since the beginning: Cayuga Medical Center has adopted the IHI
guidelines to improve care and reduce MRSA and other infections. The IHI
recommendations are implemented and carefully tracked as one of our Infection
Control Department’s core measurements for monitoring performance improvement
in this important area of hospital care.
Cooley is a registered nurse and the Infection Control Practitioner at Cayuga
Medical Center. She is certified in infection control and has been practicing
in the field for 14 years.