"Not being able to govern events, I govern myself." ~ Michel de Montaigne
Exclusive to STR
October 22, 2007
The most recent article on the subject of community acquired methicillin resistant Staphylococcus aureus was published on MSNBC on October 18, 2007 . I urge everybody to read it, because it affects us all. I would like to add some comments.
I started working in hospitals in 1963, before Medicare. Until the mid-1970s, hospitals practiced rigorous infection control. Any patient with an infection that could spread was isolated, and any person entering that room had to put on a mask, gown, gloves, hat, and booties, and walk across a mat saturated with disinfectant. Cross infections to other patients were rare.
Around 1975, the door mats disappeared and then the other protective gear. It's too expensive, I was told. It doesn't work, I was told. And about this time we were beginning to have great success with the new life support systems becoming available. We had a new kind of ward for trauma-injured people on breathing machines, and we had a neonatal intensive care for premature babies on breathing machines. Technicians like me walked from one ward to the other routinely. You can predict what happened next. Lung infections in the adult ward started showing up in the preemie ward.
In the face of the obvious, some of the old infection control procedures were revived, which took care of the problem for a while. But a completely unexpected problem took its place. The newly emerging EMT professionals were resuscitating patients in the field and bringing them to the ER alive and we were keeping them alive with the new machines and medications, but they were sometimes brain-dead. I don't mean unconscious or in coma, I mean they had no brain function at all on EEG. What to do? Nobody knew.
Nature does not tolerate a situation like this and those patients were immediately attacked by common everyday bacteria against which their immune systems soon had no effective defense. Pneumonia, 'the old man's friend,' quickly set in. Antibiotics were applied. It resolved. A urinary tract infection appeared. More antibiotics. It resolved. A colon infection appeared. More antibiotics. This would happen over and over and over. Then the bacteria began to mutate. MRSA was born.
I have seen such patients last for up to three years before they literally rotted to death. By that time the whole arsenal of drugs had been used. One of the powerful newer antibiotics is called vancomycin. As you might expect, VRSA has emerged from these patients. Still confined to hospitals, as far as I know, this form of staph is bound to escape into the community. The sloppy infection control procedures almost guarantee it.
I will not address the touchy issue of keeping brain-dead people alive, but as long as this is being done, those patients should be in a specialized maximum-isolation facility. Why are they not? And why are current procedures so sloppy?
Who controls medical money, medical schools, medical research, medical drugs, medical devices, hospitals, and standards of practice? Federal and state bureaucrats. The CDC, to mention only one agency, is reluctant to discuss MRSA , although the media is pressing them into doing so. It's not Asian or African like Bird Flu, SARS or AIDS, it's American, so they don't want to talk about it. The CDC is now saying, oh it's an old problem (it isn't), we're on top of it (they aren't), and you won't get it if you wash your hands (false). CA- MRSA can be on any surface that many people touch, like a grocery cart or door handle or football. The CDC has an epidemic, but not the one it wanted, so they're blaming the victims, ducking the issue, and covering up as fast as possible.
Read all you can find, get some staphAseptic, and take care. There is a killer on the loose and the bureaucrats cannot protect us.