An agitated vet called to sound an alarm about the John L. McClellan
Memorial Veterans Hospital in Little Rock, where he’d been a patient.
“They’re sending people home with staph!” he said. “They’ve got staph
all over the hospital!”

Staph on the loose sounds pretty scary (even if you’re not sure
what staph is), and it develops that there’s some truth in what the
man said.  But, according to a spokesman, the hospital’s practices are
not cause for alarm, and are in fact aimed at controlling the spread of
staph. Our caller was doubtless told that at the hospital. He was not
reassured.

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Staph is short for staphylococcus, a kind of bacteria that
can cause disease. The species of staph under discussion here is
Methicillin-Resistant Staphylococcus Aureus, also called MRSA.
Sometimes it’s referred to as a “super bug.” And sometimes, very
rarely, it can cause a serious, rapidly spreading skin infection that
gets it referred to as “flesh-eating bacteria.” Only a handful of
flesh-eating cases have been reported, medical authorities say. Try to
forget about it.

But even the more common MRSA can cause serious infection, sometimes
life-threatening if left untreated. And, as the official name suggests,
MRSA is resistant to antibiotics used to kill other kinds of staph.

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“MRSA was first identified in the 1960s and was mainly found in
hospitals and nursing homes,” according to a veterans hospital
brochure. “This occurred because antibiotics were being given to people
when they weren’t needed, and patients weren’t taking antibiotics as
directed. In the late 1990s, a new type of MRSA was identified. This
type of MRSA is becoming more common among children and adults who do
not have medical problems.”

You can get MRSA the same way you can get a cold, such as touching
someone or something that has the bacteria on it and then touching your
eyes and your nose. You can reduce your chances of getting it by
washing your hands often. Some antibiotics actually spread MRSA, so you
may increase your chances of getting it if you take antibiotics a lot,
take them without a prescription or don’t follow directions when taking
them, such as stopping early or missing doses.

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If you get MRSA, there are two ways you can have it. One is an
active infection, usually on the skin, such as a boil, a sore or an
infected cut. The other is to be a carrier (“colonized”), having no
symptoms yourself but with MRSA bacteria living on your skin and in
your nose that can spread to other people. MRSA is transient; it can go
away and come back.

Four years ago, a veterans hospital in Pittsburgh concluded,
reasonably enough, that it could better control the spread of MRSA if
it knew who had MRSA, and where they got it. So the hospital
began keeping records. Q-tips were used to swab inside the nose of
every patient – those being admitted, no matter the reason for
admission, and those leaving. A patient with an MRSA infection was
treated with antibiotics. People who were only colonized weren’t
treated but were put in rooms by themselves or with other patients who
had MRSA, and were cared for by hospital personnel wearing gloves and
sometimes gowns. They left the hospital with advice on preventing the
spread of MRSA. Eventually, the Veterans Administration in Washington
decided that the Pittsburgh study was useful and that all veterans
hospitals should do the same. McClellan is the only hospital in Little
Rock that tests every patient for MRSA, according to the spokesman.

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“We’re doing it every day,” Laurie T. Driver said. “We send our
numbers in monthly.” Driver is a public affairs specialist with the
Central Arkansas Veterans Healthcare System.

From September through December 2007, 13.2 percent of the patients
admitted to the hospital were found to have the MRSA bug in their nose.
Of the patients who were discharged, 1.2 percent who hadn’t had MRSA
when they came in had it when they left. They got the bug in the
hospital, in other words. Only one patient who got MRSA in the hospital
developed an infection.

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Unless strict precautions are taken, it’s comparatively easy to
acquire MRSA in a hospital. That’s because hospitals are full of people
who’re particularly vulnerable to MRSA – the elderly, those who’ve had
surgery, those with weakened immune systems, those with serious
underlying health problems. Nursing homes are even worse.

The advice given on preventing MRSA infection is very much like the advice your mother gave you, and she’d never heard of MRSA:

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“Clean your hands. Use soap and warm water. Clean your hands before
touching or eating food. Clean them after you use the bathroom, take
out the trash, change a diaper, visit someone who is ill, or play with
a pet. … Cover your mouth and nose when you sneeze or cough. … If you
are sick, stay away from other people.” And one your mother probably
didn’t tell you – “Make sure health care providers clean their hands
and wear gloves.”

Antibiotics exist that can be used against MRSA, but as our caller
learned while he was in the hospital, veterans hospitals are adamant
that the antibiotics will be given only to patients who are actually
sick or who’ve had surgery, not to people who are merely colonized.
This is intended to prevent MRSA from becoming resistant to the current
treatments, the hospitals say.

“This country has abused antibiotics for years,” Driver said. “The
more we use antibiotics, the more the germs keep mutating, becoming
resistant. And if you just have a runny nose, you’re going to get
better in 72 hours anyway.”

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