By Henrylito D. Tacio

LAST October, Jennifer came to the hospital for routine coronary bypass
surgery.  The operation had been successful, the surgeons said.  "She'll be
confined in the hospital for at least a week," the doctors told her
husband, Daniel.

True enough.  But within hours of returning home, Jennifer collapsed. Tests
confirmed she had MRSA, and she died from blood poisoning four days later.
"How did it happen?" Daniel wondered.

MRSA stands for methicillin-resistant Staphylococcus aureus, but is
shorthand for any strain of Staphylococcus bacteria which is resistant to
one or more conventional antibiotics.  It is also called 'golden staph' or
'superbug.'  There are many different strains of MRSA, with differing
degrees of immunity to the effects of various antibiotics.

According to the U.S. Center for Disease Control and Prevention (CDC),
'staphylococcus aureus' are bacteria commonly found on the skin or in noses
of healthy people. Most staph infections are minor, but the bacteria can
also cause serious infections in surgical wounds, even pneumonia.

MRSA, doctors claim, is resistant to virtually all antibiotics, and the
more cases of infection there are, the more likely it is that strains of
the bacteria will emerge that are resistant to "last resort" antibiotics,
such as vancomycin.  The symptoms of MRSA infection are boils, wounds that
will not heal, fever and acute pain. These lead to blood poisoning and the
devastation of internal organs and bones.

In the United Kingdom, deaths from the superbug have been increasing
through the years.  Recent statistics showed that MRSA caused 51 deaths in
England and Wales in 1993, but by 2002, the figure had soared to 800. Cases
of MRSA infection rose 24-fold, from 210 to 5309, during the same period.

Even in the healthy-conscious United States, the MRSA is taking its toll.
Deaths linked to MRSA represent the fourth leading cause of mortality among
Americans, behind major heart diseases, cancer and lung ailments.  "These
infections kill more people each year than motor-vehicle accidents, fires
and drowning combined," wrote Michael J. Berens in an article which
appeared in 'The Chicago Tribune.'

The most likely place to pick up MRSA is in - would you believe? -
hospitals. They have been cultured from hospital equipment, doorknobs, and
bedrails. It has also been cultured on the hands of hospital personnel.
"The longer patients stay in hospital, the more likely they are to acquire
hospital bacteria. Many patients have the misconception that they are
'safe' when they stay in hospital. However, it is safer to discharge them
as soon as they are fit to reduce the chance of acquiring these
infections," clarifies Dr. Alfred Cheng, head of the cardiac clinic at the
Mt Elizabeth Medical Center in Singapore.

MRSA infection usually develops in hospitalized patients who are elderly or
very sick or who have an open wound (such as a bedsore) or a tube going
into their body (such as a urinary catheter or intravenous catheter). "MRSA
infections acquired in hospitals and healthcare settings can be severe,"
the CDC warns.

In addition, certain factors can put some patients at higher risk for MRSA
including prolonged hospital stay, receiving broad-spectrum antibiotics,
being hospitalized in an intensive care or burn unit, spending time close
to other patients with MRSA, having recent surgery, or carrying MRSA in the
nose without developing illness.

"Staph bacteria and MRSA can spread among people having close contact with
infected people," the CDC informs.  "MRSA is almost always spread by direct
physical contact, and not through the air. Spread may also occur through
indirect contact by touching objects (that is, towels, sheets, wound
dressings, clothes, workout areas, sports equipment) contaminated by the
infected skin of a person with MRSA or staph bacteria."

The superbugs are spreading across the globe.  "Hospital acquired
infections are serious problems worldwide," deplores Dr. Cheng.

Even in the Philippines.  "Hospital-acquired infections are likewise
prevalent in the country," says Dr. Rafael D. Castillo, chair of the
department of medicine of the Manila Sanitarium and Hospital.  "I just
don't have the statistics on how serious the problem is."

The very clean Singapore is not spared.  "We have a problem here, too,
especially with the superbugs like MRSA and VRE," says Dr. Mun San Lam, an
infectious disease consultant physician with the Mount Elizabeth Medical
Center in Singapore.  VRE stands for vancomycin-resistant enterococcus. The
VRE bacteria have the ability to cause a wide range of infections,
primarily serious infections in hospital patients (particularly in
intensive care units.  

"VRE is dangerous because it cannot be controlled with antibiotics, and it
causes life-threatening infections in people with compromised immune
systems - the very young, the very old, and the very ill," explains Dr. Cheng.

Despite taking all the necessary precautions, Dr. Lam laments, "we still
see a definite number of these hospital-acquired infections." After all,
the superbugs are robust and VRE germs, for instance, are found on hospital
personnel's hands after five seconds of hand washing.

"They are well entrenched and difficult to prevent in some circumstances
and this happens even in the best hospitals," Dr. Lam says. 

According to medical experts, adopting basic hygiene practices can largely
control hospital-acquired infections.  In the past, hospitals took cleaning
seriously. The famous Florence Nightingale reduced the fatality rate of
wounded soldiers in the Crimea from 40 per cent to just five per cent
merely by imposing basic standards of hygiene and sanitation.

"We strongly emphasize strict handwashing among patients, doctors and
hospital personnel before and after handling/seeing patients.  We also
strictly enforce the "no visitors allowed" policy, especially among
susceptible patients like those with low white cell counts," says Dr Sandra
V. Navarra, of the University of Santo Tomas Hospital and St. Luke's
Medical Center.

Infections can occur after many types of medical procedures, particularly
if you are having surgery. But there are things you can do to ward off a
nasty bug, according to the U.S. National Patient Safety Foundation:

• As a patient, do not hesitate to remind doctors and nurses about washing
  their hands before working with you.
  
• If you have an intravenous catheter, keep the skin around the dressing
  clean and dry. Tell your nurse promptly if the dressing works loose or gets
  wet.  Likewise, if you have a dressing on a wound, let your nurse know
  promptly if it works loose or gets wet.
  
• If you have any type of catheter or drainage tube, call the attention of
  your nurse immediately if it becomes loose or dislodged.
  
• If you have diabetes, be sure that you and your doctor discuss the best
  way to control your blood sugar before, during, and after your hospital
  stay. High blood sugar increases the risk of infection noticeably.
  
• If you are overweight, losing weight will reduce the risk of infection
  following surgery.
  
• If you are a smoker, you should consider a smoking cessation program.
  This will reduce the chance of developing a lung infection while in the
  hospital and may also improve your healing abilities following surgery.
  
• Carefully follow your doctor's instructions regarding breathing
  treatments and getting out of bed. Don't be afraid to ask for help, advice,
  or sufficient pain medications!
  
• If possible, ask your friends and relatives not to visit if they
  themselves feel ill.

And here's a good news from Dr. Castillo: "Most major hospitals now have a
quality-control program to make sure that the hospital complies with
standard precautions to maintain cleanliness and sanitation to prevent
hospital-acquired infections."

ooOoo