Just over a year ago, 83-year-old John McCleary went to the hospital with a minor ankle fracture. After treatment and 12 days of rehabilitation, he was released.
"He was home for a day-and-a-half and he collapsed with a fever, and he went back in and it took six days for them to diagnose his MRSA," says McCleary's daughter, Kathy Day. "That was disturbing to me on many levels. He was in the hospital for 20 more days and he was in the nursing home for seven weeks before he died. For that entire six days, people cared for him, visited him, and all were exposed to MRSA."
McCleary's caretakers and visitors didn't catch MRSA, but his death was a wake-up call for his family. Day, a retired nurse, has become an advocate for screening incoming patients to see if they are more likely to carry the bacterial infection.
MRSA is short for Methicillin-resistant Staphylococcus aureus. It's a bacterial infection that is highly resistant to some antibiotics. Day says there are several groups of patients considered to be at risk: "Patients that are transferred from other hospitals, intensive care unit patients, nursing home patients, people that have been in a hospital within six months, dialysis patients and patients that come in from prisons."
According to the Maine Nurses' Association, 68 out of every 1000 Maine hospital patients contract MRSA. It can cause urinary tract infections, septicemia, toxic shock and death. Everyone's at risk for contracting the infection.
"MRSA does stay on objects for up to seven days -- you can get it in the community as well as in the hospital," says Dawn Kerekesm an emergency room nurse at Houlton Regional Hospital and the government liason for the Maine State Nurses Association. "It takes very expensive medications to actually cure," she says. "It's not incurable but once you're a carrier of MRSA you're always a carrier of MRSA but you may not be able to spread it. With the treatments we make it so that you may not be able to pass it on to somebody else."
Kerekes and Day spoke at the Maine Nurses Association's annual meeting in Brewer about the law they helped craft to require screening of high-risk patients. The law requires hospitals to screen for MRSA but does not dictate further action, such as isolation, precaution, and treatment if a patient is diagnosed.
Mary Mayhew, vice president of the Maine Hospital Association, says hospitals are already using all available resources to prevent the spread of MRSA and other infections. "Standard precautions, from gown and glove requirements, isolation where that is possible. But there are evidence-based precautions that hospitals comply with when a patient has tested positive for MRSA."
Mayhew points out that Maine hospitals will be in compliance with federal CDC guidelines. The state's Maine Quality Forum has determined that screenings must take place for six months so that hospitals can identify their individual high-risk populations. Pending the result, hospitals may terminate screening if they see fit. The Maine Nurses Asssociation is urging hospitals to continue screening.
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