Knowledge of MRSA

Did you know that hand washing is an effective way to prevent MRSA contamination and infection? According to a recent survey, the main source of the public’s information about MRSA, is through the media. The results of the survey have shown that there is a clear need to further educate the public on how to prevent the spread of infection. You can find a report here in The Irish Times online. Ever since my own brush with MRSA, I’ve tried to make it my business to become better informed about infection control and to spread the word.

MRSA is a subject close to the heart of The Biopsy Report. Consistently, the top posts on this blog are the ones which contain information on MRSA. The most frequently used search engine terms all refer to queries about MRSA. Terms such as “boils on butt”, “do you have mrsa forever”, “antibiotic resistance”, “chances of mrsa recurrence”, “superbug news”, “what is difference between mrsa and C Diff” and “mrsa nasal swab”, appear regularly and show that there is a huge hunger out there for more information on MRSA. Two funny search terms which appeared recently were “mrsa bed and breakfast” and “steph and staph infection together.” The mind boggles to think what was going through the minds of those people?

There is no doubt that infection control would benefit from greater public awareness. The media coverage of MRSA is far from an ideal source of information because of a tendency towards a sensationalist approach. We need a well-orchestrated campaign to combat the spread of MRSA and where better to start than online. Spread the word, not the germs.

21 Responses to Knowledge of MRSA

  1. Baino says:

    Hi Steph (made it early this time). The advent of simple hygeine revolutionised 20th Century health but I worry now that we’re so ‘clean’ our resistance is affected. Although some of the conditions in your hospitals sound like they could do with a good scrub down with the old bottle of White King. (oops, my blogroll has you as “Steph or Staph”) pinched from a post long ago. . .I’ll go and change it! Cheers πŸ™‚

  2. Angry Tech says:

    Hospitals and wards (certainly round here) are quite good with the Clean Your Hands Campaign http://www.npsa.nhs.uk/cleanyourhands with bottles of wash before you enter, large posters on the wall and even large floor stickers and even some hospitals have audible warnings telling you what to do.

    Most NHS Staff wear small pots so that they can wash their hands between patients. However, you would be suprised of the number of members of the public that walk past these measures and still do not wash their hands as they enter the wards!

    One thing that concerns me is that many other things come in to contact with other patients with little to no cleaning taking place. Stethascopes and Blood Pressure Cuffs….

    ….I did hear of a hospital that gives every patient that arrives at their A&E dept a disposable Blood Pressure Cuff which they then take with them to any ward that they go to during their stay – what a great idea!!! If only they thought one step forward and gave them to them when they got in the Ambulance……

    ….Nice Blog!

  3. Grannymar says:

    This is something we need to take very seriously. We all have a part to play in the prevention of passing MRSA both in hospitals and at home. I agree with Angry Tech that the disposable Blood Pressure Cuff is a step in the right direction.

    Washing hands should be a matter of form and routine for all of us. I was thinking of non medical ways in which bugs can be passed along. Patients read newspapers or magazines to while away the long hours of the day. It is normal to pass these to others when finished with our copy. I have known staff to come and ‘borrow’ them to read on meal breaks.

    How do patients get these items? Mostly they purchase them from the hospital shop trolley. They hand over money and often need change >>> the same warm coins used by other patients to purchase items minutes earlier……

  4. Steph says:

    What a treat to get up on a Saturday morning to THREE comments. Thanks! folks

    Baino – Don’t change the ‘Steph or Staph’. I love it! It’s very YOU and it’s also appropriately, very ME as almost daily someone keys in ‘Steph infection’ on the blog. Good friends used to joke me by calling me Staph when I was in the throws of MRSA. My nickname of Mrs B also got changed to MRS A!

    Angry Tech – You’re so right about blood pressure cuffs etc. I’m sure that’s how I contracted MRSA in the first place as I shared a small four bedded room post-operatively with another lady who turned out to have MRSA infected leg ulcers. We didn’t know she was infected at the time and of course, all the nurses moved between us without washing/disinfecting their hands. One of the other patients in the room, an elderly lady, was post-operative as well (mastectomy) and I’ve often wondered how she fared.

    When I ended up in the MRSA isolation unit surrounded by MRSA patients, I used to lie there watching the nurses go from patient to patient with very little evidence of an infection control protocol. It was as if the attitude was “everyone here is infected or colonised anyway so don’t worry about it”. I well remember thinking “what chance have I of ever getting out of here with the risk of cross-infection?”

    Grannymar – you’re so right! We do all have a role to play in stopping the spread of germs. Simple measures and a general change of attitude (without becoming neurotic about it) all add up to having an impact. I’m sure we’ve all experienced having our blood pressure taken where the BP cuff was still warm from the last patient. This practice has to change.

  5. Bendy Girl says:

    I went to visit my mother recently who was on a heamatology (I can’t spell it but everyone on the ward was frighteningly vulnerable to infection) ward. There was the by now standard alcohol gel dispenser at the entrance to the ward, which I went to use and then realised it was too high up the wall for me to reach properly. That meant too high for children under about 11/12, too high for wheelchair access etc. They are also a major problem if you have your hands in braces/a drip in etc.
    Like most things in the NHS, great idea destroyed by not being thought through properly.
    However, I didn’t worry too much when I was on the ward as my mother was doing a great job of spreading infection around for them πŸ˜‰
    BG x

  6. Steph says:

    BG – Well done for pointing out that very basic error. The NHS needs to listen to it’s service users. When you’ve finished sorting out the NHS, could you come over here and sort us out too, please! πŸ˜€

    And well done for making that visit. It can’t have been easy for you.

  7. Ian says:

    Angry Tech’s mention of the stethoscopes reminded me that I have seen doctors go from patient to patient without ever sterilising the stethoscope. Some seem to wear it as a badge of office even when they are not using it.

  8. Thanks, we need to spread the news and educate people because the Govt is busy cleaning hospitals and burning our hard earned money.
    I have been publishing information about this “Threat to Mankind” since 2004.
    Please check out my videos in youtube : “Medifix” and my website “Safecannula.com” has all the news and information you need to protect yourself in the hospitals and in the community

  9. Miike says:

    Steph
    Your blog is the type of media coverage thats needed about MRSA not spin!
    Hygene stars at the point of entry to a hospital. I was in St Vincents hospital recently and no one appeared to be using the estandard alcohol gel dispenser in the entrence foyer

  10. Steph says:

    Thanks everyone.

    There is no doubt that better education is needed. We also needs attitudes to change. Hospitals are no longer the safe haven they once were. We all need to take more responsibility for our actions and wake-up to the war against superbugs.

  11. robert says:

    When himself was born 8 months ago in the new Maternity Hospital in Cork, there were (and more than likely still are) handwash stations everywhere.

    As far as I could tell I was the only person to use them!

    The delivery wards are a security protected area and no one other than husband/partner are allowed in there so you have to press a buzzer to be allowed in. Right beside the buzzer is one of those dispensers. While waiting for the door to be opened I was amazed that I was the only one in the queue rubbing my hands together with the gel.

    It should be mandatory for anyone visiting any hospital but I would reckon 9 out of 10 persons just walk right pass them. Despite them being very prominent. Of course as can be expected some of the bottles were empty 😐

  12. Kimberly says:

    As a nurse I chuckle at some of the comments here, not in a bad way though. The hospital is a germ incubator. Yes, using the hand wash and just old fashion hand washing are great ways to stop the spread of all germs that may be on the surface of your hands. MRSA is commonly blood borne or respiratory ( reason for the nasal swabs). MRSA is relentless. I guarntee you a majority of us would test positive but that is not an issue until we become compromised (immune wise) and the MRSA colonizes. I know that I personal use wipes on my stethoscope between patients and I never take it in an isolation room. Matter fact when it comes to isolation strip down and gown and glove up is what I do. Chances may be slim that sharing a cuff with someone with MRSA will pass it on unless they leave body fluids and you have open wounds. The skin is a great barrier but needs to be washed often.

    Sorry for anyone that has contracted active MRSA, yuck. Good Luck.

  13. Steph says:

    Hi! Robert

    Weren’t you lucky to get to use a new maternity hospital. Well-timed! You went in rubbing your hands together with gel and came out rubbing them with glee! πŸ˜€

    Your observation on the failure of others to use the hand gel, confirms exactly what I’ve been saying. Attitudes need to change. People have to realise that they can make a difference by simply washing/disinfecting their hands. I think if the HSE was to introduce a bit of humour into a hand washing education campaign, it would have a bigger impact on the general public.

    Kimberly – Hello! and welcome.

    We had a recent survey carried out in Ireland which found that 16 per cent of patients entering hospital routinely were found to be carriers* of MRSA. I’ve heard tell that this figure could realistically be as high as 30 per cent. That says two things to me. Firstly, if up to 30 per cent of the population is colonised and doesn’t know it, then it’s even more reason to take hand washing seriously. And secondly, as Irish hospitals do not have the infrastructure in place to isolate enough patients, then we need to improve on pre-admission diagnostic testing to keep MRSA out of our hospitals.

    As regards your comment on sharing a BP cuff, I’m not sure I agree with you. Sharing anything with someone who is infected with MRSA has the potential to ‘colonise’ another patient. If that patient then goes on to have surgery, it’s an open invitation for MRSA to walk right in. As I know well to my cost!

    * Note – a carrier refers to someone who is ‘colonised’ (not infected) with MRSA.

  14. neha010704 says:

    Hi, NICE POST!! Really, while trying to prevent infections by one means or the other we tend to forget the basic things like washing our hands. With increasing resistance of microorganisms especially in cases of nosocomial infections, it becomes extremely important for the doctors as well as the nursing staff to take steps to prevent such infections by not forgetting to keep in mind about hygiene and washing their hands.

  15. Steph says:

    Cheers! neha

    I couldn’t agree more!The onus should be on EVERYBODY to take more care.

    Both of my elderly parents are in a nursing home where there are lots of ill and frail residents. I always make sure to wash my hands when I arrive to visit and apply gel and I do the same as I leave, every time. I’ve never seen one other visitor wash their hands. Why is this? I think some of it is due to ignorance but I also suspect that many people are embarrassed to be seen to make a fuss about hygiene. It’s not called making a fuss, it’s called saving lives!

  16. Knipex says:

    Great post Steph.

    I need to make one comment though.

    Those alcohol based hand scrubs that people keep mentioning have great efficacy against MRSA if and only IF your hands are clean. If they are not then its a waste of time.

    Also while it is good against MRSA, VRE etc it is useless against spores such as C.diff

    Finally in response to Kimberly’s post.

    It is well proved that blood pressure cuffs carry MRSA (and other pathogens) I agree that to most people this would not be a problem. If a cuff is contaminated with MRSA and it touches a patient then it will transfer onto that patient. Once on their skin it can grow and spread so that patient becomes colonised and there after that patient is capable of contaminating surfaces.

    Boyce, Bhalla and Dancer have done a number of studies showing how easy it is to spread MRSA.

    Imagine the following scenario,

    Nurse washes her (or his) hands and comes into the patients room. She then lowers the bed rail or moves the TV remote, or touches the side of the bed, or the bedside locker.

    In 2004 Bhalla showed that after 5 seconds of contact with any of these surfaces that hands became contaminated. He chose 5 seconds because it was easy to monitor but its well known that it doesn’t take 5 seconds it doesn’t even take 1.

    Its also well proven that using wipes to clean anything contaminated with C.diff is a waste of time. Indeed it only encourages the pathogen to turn into a spore making it even harder to eradicate. You need to either heat steralise or use an oxidising agent such as Hydrogen Peroxide or high concentration solution of Hypochlorite (bleach)

  17. Steph says:

    Thanks Knipex!

    I presume you’re talking about the alcohol based hand gels when you refer to needing clean hands? Not the wipes that Kimberley mentions? What’s clear to me is that there’s a lot of confusion out there as to what is good practice and we clearly need a good education campaign to bring everyone up to speed.

    I’ve no wish to cause undue concern about spreading germs but there’s no doubt that we all have to take more responsibility and use caution.

    Said “she” who’s just struggled through a bowl of Ready brek in an effort to re-colonise her gut with good bacteria πŸ˜€

  18. Knipex says:

    LOL

    ReadyBrek is actually quite nice with hot milk and a bit of sugar.

    And the bacteria in the Colon Love it.

    Also alcohol based wipes are also useless at killing C.diff so yes when treating c.diff patients wiping a stethoscope with an alcohol wipe is ineffective at removing contamination (same is true for all bacterial spores and fungal infections). You must use an oxidiser such as Hydrogen Peroxide or High concentration of hypochlorite. (6 ppm at least)

  19. Steph says:

    Knipex

    I have this image now of the bacteria in my gut having a right ol’ party. I’m wondering if they’d prefer the chocolate flavoured version tomorrow? πŸ˜†

  20. Knipex says:

    hmmmmmmm

    Chocolate… Although in my experience it does not quite turn out as good as it sounds.

  21. […] wrote a post recently lamenting the lack of information available to the public on MRSA and suggested that a […]

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