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Consumer groups seize on MRSA study
Urging legislatures, governors to take action
Consumer groups, patient safety advocates, and critics of the health care system are expressing outrage and demanding action after the highly publicized release of a study that showed methicillin-resistant Staphylococcus aureus (MRSA) prevalence in the nation's hospitals is at least eight times higher than previously estimated.
The study by the Association for Professionals in Infection Control and Epidemiology (APIC) was unveiled recently in San Jose at the annual APIC conference. With national media outlets jumping on the story, the findings immediately energized the ongoing issue of state laws requiring hospitals to adopt measures such as active surveillance cultures (ASC).
"We are clearly telling reporters that this is just one bug, and that legislatures cannot legislate the bug of the month per se," Denise Graham, vice president of public policy at APIC, told conference attendees. "You need to identify your MRSA reservoir, but that is just one component of the plan. This is what we are telling legislatures and the press, but the press like emotional stories, and this is an emotional issue."
Though emphasizing the common goal of patient safety means the Consumers Union "isn't the enemy," she warned ICPs that the consumer advocacy group is sending letters to "every single governor asking them to speak to [their state] hospital administrators and ask them how many do active surveillance." And that was before the MRSA study was released.
Best known as publishers of Consumer Reports magazines, the Consumers Union is encouraging people to join in the letter writing campaign to governors and other state "decision makers." A template for such letters posted on the group's web (www.StopHospitalInfections.org) states that: "All hospitals should be using 'active surveillance,' which has been validated by more than 100 studies around the world as an effective prevention technique. The Centers for Disease Control and Prevention and the Society for Healthcare Epidemiology of America have issued guidelines that describe the procedures for active surveillance. Most hospitals are familiar with these, yet few choose to use them. We are asking you to direct our state health agency to survey all hospitals to find out which ones are using active surveillance to prevent MRSA. We are asking for that information to be provided to the state legislature in a public report. We have a right to know which hospitals are using these successful evidence-based techniques."
With that campaign already under way, the Consumers Union issued a press release when the APIC study was released that underscored its message that hospitals must take aggressive steps to protect patients from infections.
"MRSA is lurking in every U.S. hospital and poses a serious and sometimes deadly health risk to patients who are unwittingly exposed to these superbugs," said Lisa McGiffert, director of Consumers Union's Stop Hospital Infections Campaign. "Unfortunately, most hospitals are not doing enough to keep these antibiotic-resistant germs in check. It's time for hospitals to aggressively step up their efforts to protect patients from these preventable infections. We know how to control MRSA, but most U.S. hospitals are not consistently following these successful infection control practices."
Another take on the MRSA prevalence study came from the Committee to Reduce Infection Deaths (www.hospitalinfection.org), a national patient safety advocacy group chaired by Betsy McCaughey, former lieutenant governor of New York. The findings of such a high level of MRSA prevalence in U.S. hospitals shows "the dangerous flaws in the policies of the Centers for Disease Control and Prevention," she said in a statement. "For 30 years, the CDC has collected data monthly tracking the rapid rise of drug-resistant infections, but has done almost nothing to stop it." The group charged that the CDC has "delayed" calling on hospitals to screen incoming patients for the MRSA bacterium despite numerous studies demonstrating that hospital infections cannot be prevented without knowing which patients are carrying the germ.
Asked about such criticisms, John Jernigan, MD, a medical epidemiologist in the CDC division of healthcare quality promotion, defended the approach outlined in the CDC's 2006 guidelines on multidrug-resistant organisms (MDRO). The MDRO guideline outlines a two-tier approach, with hospitals going to more aggressive measures like ASC if rates are not going down.2 "If they are not [reducing rates], then the guideline says you need to do more," he tells Hospital Infection Control. "And in fact active surveillance is part of those [additional] recommendations."