MRSA Update


Michael J. Berens and Ken Armstrong, staff reporters at the Seattle Times, deserve a Pulitzer Prize for their extensive investigative reports on MRSA (methicillin-resistant Staphylococcus aureus). The subject is not new to me and I have written about it several times in this space, but their presentation gave me facts I never knew, like how long MRSA has been around.

The reporters write that staph infections resistant to penicillin-type antibiotics emerged in hospitals during the 1970s. One would think that this information would be vitally important to patient care personnel. I had been working in critical care since 1963, and I never heard about it in continuing education lectures or read about it in the literature. I did not know anything about MRSA until I took a close look at isolation signs posted on patient’s doors in the mid-1990s, and then I had to ask what it meant.

As I was reading the above linked article, I was struck by the time frame. MRSA evidently appeared at about the same time our old-fashioned isolation procedures disappeared, as I described here. Not coincidentally, I think, it was also about the time that business school—educated hospital administrators began to be hired by hospital boards to manage the business. Hospital boards of directors are seldom, if ever, medical professionals themselves, so it was a case of the blind leading the blind, otherwise known as a bureaucracy. In my experience, they were far more concerned with hospital cosmetics than with the messy details of patient care.

The reporters also describe the concerted efforts of hospitals to hide or cover up the frequency of infection and the mortality of infection. Often it was one lone crusader against a legion of lobbyists, and congress critters voted reform proposals down. While I’m sure hospitals don’t want the public to be able to judge them on the basis of facts, I think the real culprit nationwide is the CDC. This agency has effectively stonewalled any effort to establish infection control procedures in hospitals for decades. Why?

I don’t know, but I must wonder whose hand is in whose pocket. The hand with the biggest stake in this game is big pharma and to them being sick unto death means money. The CDC covers itself by focusing attention on non-existent problems. Meanwhile, we have an epidemic that’s becoming worse by the day. MRSA can only be treated with high-powered antibiotics, like Vancomycin. So we have VRSA waiting for us in hospitals. We also have VRE and C. Diff. and TB. These highly communicable bacterial infections can be stopped, or nearly stopped, by rigorous infection control procedures.

I urge you to read the entire series by Berens and Armstrong. It’s fine work.