Thursday, May 23, 2013
MRSA Cases in Alaska Increase Part I
The Alaska Dept. of Health and Social Services doesn’t consider MRSA a reportable condition, which makes tracking its prevalence a challenge.
On the heels of the discovery of Methicillin-resistant Staphylococcus Aureus, or MRSA, the drug-resistant Staph infection in the neonatal intensive care unit of Providence, new questions are being raised about the state's tracking of the sometimes fatal infections.
“It is a bacteria that is resistant to a group of antibiotic,” said Medical Epidemiologist Dr. Beth Funk of the State of Alaska Department of Health & Social Services.
That resistance is what can make MRSA infections so dangerous.
In the past, most MRSA infections happened in hospitals and other health care institutions and the most recent cases of MRSA in Alaska were found on the skin of infants in the Providence NICU in April 2011.
“We are segregating the babies that we know have it. Even though they are not sick from the babies that we know don’t have it right now,” said Dr. Lily Lou, neonatologist and director of the Providence NICU. “It's just on their skin.”
MRSA found on the skin does not necessarily make a person sick.
What does make a person sick is if MRSA makes its way into the bloodstream.
“In the hospital setting, if a person is colonized or even has it in their bloodstream or related to a catheter they have, it could be that the health care worker is taking care of that patient and gets it on their hands or even maybe clothing,” explained Dr. Funk.
“Then if they don’t clean their hands really well and then they go to take care of another patient, they can transfer it from patient to patient.”
Because most MRSA cases were happening in health care settings, the state did not track them. The mentality was that public health was not needed because the facilities had their own infection control.
But now all of that is changing.
According to the Centers for Disease Control, national numbers show fatal cases of MRSA originating in hospitals are declining.
While the State Department of Health does not track it, a 2009 report based on local hospital discharge data, which includes about 85 percent of everyone hospitalized from 2001 to 2006 shows that people sickened by MRSA is on the rise.
The report refers to "statistically significant" increases with suspected MRSA cases rising about 30 percent.
Community-contracted MRSA is also now on the rise.
“They seem to be two different kinds of problems and maybe even different kinds of germs,” says Dr. Funk. “They are different kinds of MRSA strains.”
In August 2000, there was an outbreak of MRSA in southwest Alaska among people with no history of hospital exposure. After an investigation, the cases were traced back to steam baths in communities.
According to a Providence spokesperson, the state studies that show MRSA is on the rise do not provide a real picture of what is happening because there is no requirement to report all MRSA infections.
Now the state is considering requiring hospitals and other health care institutions report any MRSA infections to get a better idea of what is happening.
“It is something we are discussing here at this point, and one of the first things we might consider would be reporting health care-associated invasive MRSA infection,” said Dr. Funk, “But that takes some time to do."
In order to track MRSA, health care regulations must be changed and followed by a public comment period that could take years.