COMMENTARY

Spread of MRSA: Past Time for Action

Thomas Ward, MD

Disclosures

February 08, 2008


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There is now no doubt that we have a rising threat of methicillin-resistant Staphylococcus aureus, or MRSA, infection both inside and outside our US hospitals.

A study published in the October 17, 2007, issue of the Journal of the American Medical Association described the frequency of invasive or more severe MRSA infection in 9 geographically separated communities across the United States.[1] The CDC [Centers for Disease Control] study group concluded that in 2005, there were approximately 90,000 persons diagnosed with severe MRSA infection, mostly elderly, and an estimated 19,000 patients died.

The majority of severe MRSA infections were acquired during hospital stays or as a result of prior contact with medical care facilities, underscoring the importance of efforts directed at reducing hospital transmission.[2]

Adding to the concern posed by MRSA acquired within hospitals is the rapid rise in numbers of MRSA infections acquired from within community settings. Community-acquired MRSA has been shown to cause the majority of soft tissue abscesses in patients seen in US emergency rooms, with infections often involving healthy younger adults and children.[3]

Medical professionals must lead the cultural transformation within our healthcare settings necessary to slow the spread of MRSA.

Within the hospital, we all need to better incorporate proven methods of infection control, such as improved hand hygiene, compliance with the use of protective gowns and gloves where appropriate, and wiser antimicrobial stewardship.

In the outpatient settings, we can help control the spread of MRSA by recognizing its importance in causing soft tissue abscesses, confirming infection by performing appropriate cultures, and by emphasizing to our patients the importance of good hygiene, keeping draining lesions covered, and reminding patients and their families to not share personal items.

The threat of MRSA is real, and it is past time for more concerted efforts by all.

That's my opinion. I'm Dr. Thomas Ward, Chief, Infectious Diseases, Portland Oregon VA Medical Center.


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