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Tuesday, October 11, 2005
Sleeping in death beds
By Henrylito D. Tacio
Health 101
RECENTLY, 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 US 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.
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.
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).
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.
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.
"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 hand washing 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.
For comments and feedback, write me at tasyo2002@yahoo.com
For Bisaya stories from Davao. Click here. (October 11, 2005 issue)
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