It is everywhere. You cannot escape it. But the chances are fairly good that you’ll be able to survive it, only somewhat worse for the wear.
Methicillin-resistant staphylococcus aureus (MRSA, pronounced “mursah”) is making headlines since taking the lives of several students and other victims in the nation. The superbug, however, is hardly the only staph out there, and staph is not the only targeted disease in Mississippi hospitals’ and clinics’ efforts at containment.
“MRSA started showing up in 1999, so it’s been around for eight or nine years,” says Dr. Ralph Kahler, hospital epidemiologist at Forrest General Hospital (FGH) in Hattiesburg. “It has been increasing in prevalence in the community.”
For FGH, as with other health care institutions, that equates to more vigilance and more expense. Kahler says that “of late, everyone who comes in to ICU (intensive care) or CCU (critical care) and for elective surgery is being cultured.”
Suspected staph sites on the skin are swabbed and the cells transferred in the lab to a Petri culture dish. Two to three days later, a culture, if infection is present, will give clues to the identity of the disease, and further testing will determine its sensitivity to available drugs.
Those cultures cost $50-$65 depending on the facility and the intensity of the testing.
“These cultures, which are basically preventive medicine, are not all reimbursed,” says Kahler. “It’s an added expense absorbed by the hospital. We would have to hire another full-time medical technologist if we wanted to culture everybody — and we may have to expand in the future.”
The 460-bed Hattiesburg hospital is not alone.
“We have not had to hire extra staff,” says Kim Roberts, director of infection control in Starkville’s 96-bed Oktibbeha County Hospital, “but it could be possible in the future.”
She says her department, which currently comprises her and a nurse that works half her time with Roberts, has been budgeted an “infection control technician to compile and record data.” That already approved position is not included in Roberts’ prediction her department could grow.
Every month, Roberts meets with colleagues from other institutions through the Northeast Mississippi chapter of Association for Professionals in Infection Control and Epidemiology for “a lot of communication and information sharing.”
Most of those meetings occur in Tupelo, where North Mississippi Medical Center (NMMC) maintains a 10-member infection control staff for its main campus and more than 30 outlying facilities in Northeast Mississippi and Northwest Alabama.
“Our rooms are cleaned after patients leave them and every eight hours,” says Sheila Frederick, a registered nurse and member of the infection control team.
Another nurse and team member, Shayla Prather, explains that once a patient is identified as a MRSA victim, he is isolated and treated with antibiotics until the disease is conquered. “We’re trying to be proactive.”
The women’s colleague, nurse Richard Comer, says that “other things, like TB (tuberculosis), flu and pertussis (whooping cough) are more of a threat.”
None of the three nurses could set a dollar amount for what NMMC spends to “aggressively prevent infections,” as Comer terms it. In the microbiology lab, alone, says medical technologist Becky Easley, more than 200 cultures are run every day.
“We assist physicians in choosing antibiotics to treat with,” says Easley. In addition, NMMC hold infection-prevention workshops for staff members and education classes for area school students.
Lee Wallace, owner and nurse practitioner at Family & Urgent Care Clinic in North Tupelo, says his small practice is no different from the big ones. He may, however, be able to more easily control MRSA spread since he’s dealing with fewer patients than the larger institutions. His staff is trained to both look for symptoms and disinfect after patients depart.
“We have never had to put any MRSA patients in the hospital,” he says. Wallace employs an after-hours cleaner, who is also a medical professional, so has solid training in where to effectively clean and disinfect.
Contact MBJ contributing writer C. Richard Cotton at firstname.lastname@example.org .