I began my quest: A MRSA infection

Kathy Day’s story:
My father had a minor fracture of his ankle, and was in the hospital for 12 days of rehab, and then was home for a day and a half. Then he collapsed, and was brought back to the hospital. On admission, they diagnosed him with pneumonia. After he was in the hospital for six days and after he developed a MRSA urinary tract infection after a catheter insertion, I asked for a sputum culture (I'm a retired E.R. nurse, so I know about these things). It took them a day and a half to get the results, which showed them it was a MRSA infection. We'd been visiting him with no precautions; now they told us to use full precautions – gowns, gloves, and masks.

Dad was in the hospital for a total of 20 more days. He suffered through sepsis, complete loss of energy, appetite, and independence. He got blood transfusions, and very strong IV antibiotics. His treatment caused him thrush, a body-wide allergic reaction and loss of hearing. He had been living independently with my mother at home before. Once his acute care (hospital) was "complete" he was sent to a nursing home. He had become a totally bed-bound nursing home patient because of this, and couldn’t sit up without passing out. After nine weeks in the nursing home, in an isolation room, he became very depressed. In total, he lost a third of his body weight. He never walked again. What happened to him wasn’t so rare, as a month before he’d been admitted, two joint replacement patients had had MRSA in the same small 25-bed hospital, and had died from it.

After this happened to my father, I began my quest for MRSA prevention. I wrote letters to the hospital, did research, and came upon Jeanine Thomas, who was the founder of MRSA Survivors Network in Chicago. She's a real powerhouse! She got a law passed in Illinois. Then I wrote a proposal for Maine, got the necessary support and a sponsor, Representative Adam Goode. We passed a law in June 2009 to screen all high risk patients for MRSA on hospital admissions.

Kathy Day's advice: If someone is at risk for MRSA, e.g., they're elderly, coming from a nursing home, with ongoing health problems, or are about to have implant surgery, request MRSA screening from the admitting physician for their own safety. For an elective admission, it's best to be screened a week or two ahead of time to allow decolonization (to clear the MRSA from the patient's body) through five days of preparation, including showering daily with Hibiclens, and the ointment Mupirocin for the nose, which is a prescription antibiotic. If you test positive for MRSA before entering the hospital, you should be either isolated or cohorted (roomed with someone with a like organism).

There's a higher risk of infection for surgery involving implants, e.g., knee or hip replacements, or cardiac valve replacements.

Read Jeanine Thomas' MRSA story.

And not tell us more to protect ourselves: Three families' victims of MRSA infections

The Story of Ms. A about her husband's treatment in a South Carolina hospital:
My husband was just released after almost two months in the hospital. His hip replacement was infected by MRSA at the hospital and the only way he could get the treatment needed was to remain in the hospital. When we took him back to the hospital with the first signs of infection in his incision he was not in isolation until the tests came back from the lab that it was MRSA. The nurses did not wear gowns and treated him as they did any other patient. Once the tests were known it was a whole different case. Why the hospital didn't see the need to protect all the people the moment a person comes in with a surgical infection is beyond me. I know we will worry about this infection the rest of my husband's life and we know he got it while in the hospital for a routine surgery. In the weeks I went to the hospital to visit my husband, it was scary how many isolation boxes were hanging on patient doors on the 9th floor. Even on the 3rd floor where I walked to get to the parking garage, there were lots of boxes on doors. The bills that have started coming in since we started working with the hospital two months ago are beyond what any regular person can pay. If the hospitals are the cause of spreading this infection, they should have to treat the victims for free. Good luck to Ms. Diane Parker in taking this to a higher power to stop this infection from affecting other families [by organizing a coalition in South Carolina to reduce hospital infections]. 2/3/09


The Story of Ms. B about her father's treatment in the same South Carolina hospital:
My family had the same experience with that hospital. My dad contracted MRSA after a back surgery. He battled it for a year before sadly we lost him to this totally preventable infection. There were isolation boxes on the 9th floor, but I never saw anyone take out the gowns, gloves, or masks that were in there. The doctor didn't wash his hands when coming in or leaving the room. Neither the doctors nor nurses told the family that we should be using the gowns and gloves. It was a custodial staff member that alerted us. After asking many questions, we finally had a name for the infection and realized that our dad was in for a rough ride. Although I am not a fan of lawsuits, it seems the only thing that talks in this country is money. Hopefully, an attorney will step forward and be brave enough to take a case like this. I have been unable to find one to help me hold the hospital accountable for an unnecessary death.


Crickett's story about her mother's treatment in another South Carolina hospital:
My family experienced the same thing also. Only my mother died 34 days after contacted HAMRSA , thru an intravenous [IV] line in the hospital. She had surgery to remove an area of her arm 1 inch wide and 6 inches long of all veins and tendons. On top of that was sent home with home health to show me how to care for the wound which was left open, not stitched up. She was only treated 4 days with vancomycin, which is one of the only drugs to fight infection. And sent home on bactrim. We took her to another hospital, where she was diagnosed with Septic MRSA. Why didn't the hospital tell us she was going to die, and not tell us more about how to protect ourselves from this dangerous infection?!


On Feb. 4, the South Carolina Hospital Association, Health Sciences South Carolina and Premier Healthcare Alliance announced a major statewide effort to get rid of preventable infections. They have formed the South Carolina Healthcare Quality Trust. This group is to figure out the problems and find the solutions.

Advice to people with a family member in the hospital: Ask the nurse if the hospital participates in a multi-hospital effort to prevent hospital infections.

Read another story of a serious hospital infection in a South Carolina hospital.

Thanks to Dawndy Mercer Plank for the source story, and to Helen Haskell for publicizing this.

A state senator named Barack Obama: Disclosure of hospital infection rates

A night-shift nurse slipped into Jeanine Thomas' hospital room and whispered, "I don't know how you're taking this so well. If I were you, I'd be curled up in a ball crying."
The remark mystified Jeanine. She'd had ankle surgery, and yes, there had been complications. But she thought she was recovering. Was there something she didn't know?

In November 2000, Jeanine, then a 45-year-old antiques dealer, had slipped on ice and shattered her left ankle outside her suburban Chicago home. But days after surgery at her local hospital, the skin surrounding the incisions turned black, and her body swelled. Doctors wanted to amputate, but Jeanine, an avid tennis player, refused to let them.

Then, a friend told her about her mother's battle with MRSA, an antibiotic-resistant germ. Their symptoms matched. Jeanine confronted a doctor and learned the truth: She, too, had MRSA. Only now did the nurse's comment make sense.

Jeanine asked doctors how many people get MRSA. She was met by silence. "That's when I knew ― a light bulb went on in my head," she says. "They don't want anyone to know about this."

Jeanine epitomizes a revolt in health care. A growing number of consumer advocates ― many bound by ordeals with MRSA, or methicillin-resistant Staphylococcus aureus ― have vowed that if the U.S. hospital system will not heal itself, they will do it.
Five years ago, not a single state forced hospitals to reveal how many patients contracted infections while under their care. Now 25 states have some form of "report card" disclosure that can make hospitals more accountable.

After her ankle healed enough that she could walk, Jeanine cobbled together bits and pieces of information about a germ that few seemed to know about.

In 2003, she helped muster support for a bill requiring Illinois hospitals to disclose infection rates. A state senator named Barack Obama co-sponsored the legislation, which passed that year.

Thanks to Helen Haskell, and Seattle Times reporters Michael Berens and Ken Armstrong for the source story.

Theoretically a totally preventable disease: MRSA infections

A high school student in Bedford, Virginia who was hospitalized for more than a week with an antibiotic-resistant staph infection, has died. After a student protest, officials shut down 21 schools for cleaning to keep the illness from spreading. Ashton Bonds, 17, a senior at Staunton River High School, died Monday after being diagnosed with Methicillin-resistant Staphylococcus aureus, or MRSA, his mother said.

"I want people to know how sick it made my son," Veronica Bonds said.

MRSA is a strain of staph bacteria that does not respond to penicillin and related antibiotics but can be treated with other drugs. The infection can be spread by skin-to-skin contact or sharing an item used by an infected person, particularly one with an open wound.

Ashton went to the hospital on Oct. 4 after complaining of pain in his side, his mother said. He was sent home after doctors ruled out appendicitis, but was readmitted three days later and taken to another hospital. Last week doctors diagnosed him with a MRSA infection that had quickly spread to his kidneys, liver, lungs and the muscles around his heart. Early Thursday morning, Ashton had to be sedated and put on a ventilator. He was about to undergo surgery to drain the infection from his lungs when doctors detected a blood clot near his heart. But the clot was inoperable.

Ashton is one of 19,000 people who die each year from infections by drug-resistant bacteria. The vast majority – about 85% - of invasive MRSA infections are associated with healthcare treatment, e.g., in a hospital or nursing home, according to a study published today in the Journal of the American Medical Association.

Some hospital systems, e.g., Evanston Northwestern Healthcare, have dramatically reduced their rate of MRSA infections. Dr. Lance Peterson, an epidemiologist at ENH, said, "MRSA is theoretically a totally preventable disease."

Advice to hospitalized patients: Put up a sign near your bed asking your doctors and nurses to wash their hands.

Read another drug-resistant infection story, or read more from today’s Associated Press stories, or the New York Times article by Kevin Sack.

Even a girl in Nunavut: MRSA infections

MRSA is a problem everywhere; it even reaches into Nunavut, in northern Canada, west of Greenland.

Dr. Isaac Sobol, Nunavut's chief medical officer, who recently returned from Arviat, would not confirm any deaths due to MRSA in the community. But a reliable source told Nunatsiaq News that the superbug had killed a girl somewhere in Nunavut.

Dr. Sobol did say there are "several" other cases of MRSA in Nunavut, in various communities, although he did not want to say which ones.

MRSA has been widespread in Canadian hospitals since 1981. Community-acquired MRSA has also cropped up in aboriginal communities in the prairies over the past decade.

Dr. Sobol said a couple of Nunavut's MRSA cases have been linked to infection from hospital stays. However, MRSA has also struck Nunavummiut who have never been to a hospital.

In communities, most of the transmission appears to be from people with active MRSA skin infections. Studies show First Nations and Inuit are six times more likely to get MRSA at home because MRSA spreads easily in overcrowded living situations.

MRSA can be spread by direct contact such as kissing, sneezing or indirect contact, such as touching a surface an infected person has touched.

Dr. Sobol said Nunavut is taking steps to contain MRSA in the affected communities. He's prepared to ask stores in Nunavut to stock and promote the sale of hand sanitizers at reasonable prices. But containing the spread of MRSA may be difficult in places such as Arviat where there is acute overcrowding in most homes.

Advice to people in crowded homes: Don't share toothbrushes and face towels.

Read another of our grim MRSA stories, or read Jane George's source story in the Sept. 21 Nunatsiaq News.

Among previously healthy children and adults: MRSA

A story by the Centers for Disease Control:

Louisiana case 1. A previously healthy boy aged 10 years became ill with fever, cough, sore throat, and earache in both ears on December 6, 2006, and was treated with acetaminophen at home. The next day, his symptoms worsened and he was taken to a local Emergency Department in respiratory distress with a fever of 104°F (40°C). A chest X-ray was performed and revealed pneumonia in more than one lobe of his lungs. The patient was transferred to another hospital and admitted to the pediatric intensive care unit (PICU), where he required endotracheal intubation and mechanical ventilation. He was treated initially on December 7 with intravenous (IV) ceftriaxone; vancomycin was started the next day. On December 8, a rapid immunochromatographic assay for the qualitative detection of influenza A or B was performed on nasopharyngeal secretions and was positive for influenza A. A sputum culture obtained the same day grew MRSA; blood cultures were negative. The patient had leukopenia [a decreased number of white blood cells] and worsening hypotension (abnormally low blood pressure) and hypoxia [a shortage of oxygen in the body]. He died on December 9, approximately 42 hours after admission to the PICU. The cause of death was reported as bilateral pneumonia [in both lungs]. The patient had no documented history of MRSA; no documentation of influenza vaccination was present in either his medical record or the statewide immunization database, Louisiana Immunization Network for Kids Statewide (LINKS).

The CDC reported nine other similar cases in Lousiana and Georgia in December 2006 and January 2007. In six of them, the patient died. None had received a flu vaccine.

Advice: Write yourself a note on your calendar for the first Monday in November: Get yourselves vaccinated against the flu.

Read another flu story, or read CDC’s source story.

He'll Be Back Playing Football in the Fall: Surgical error

His mother says about her son Jimmy, "His whole life was in a team uniform," first baseball at age 4 and then football at age 7. And he was good--he'd won his local Punt, Pass and Kick competition as a child. Then at age 15 he had a bicycle accident that required outpatient knee surgery. He was told he'd be back on the football field in the fall. But he developed a staph infection, probably from a dirty surgical instrument or doctor or nurse who didn't wash their hands thoroughly enough.

MRSA (Methicillin Resistant Staphylococcus Aureus) and other bacteria had invaded his blood, bones and joints. His treatment has involved massive amounts of Vancomycin and other antibiotics, physical therapy and multiple operations. He requires bone grafts from his hip and heel to replace the lost bone damaged by infection. Now Jimmy Toolen can't go to school, and needs a cane, walker or wheelchair to get around. The hospital infection has also damaged his mother and father's health, and has wrecked them financially.

His mother Lisa Toolen has worked hard to support a state law requiring the disclosure of hospital infection rates in South Carolina. Efforts like hers have persuaded 16 states to pass some form of public reporting law. She has told her story to the Consumer Reports organization, which is collecting these stories.

Advice for parents: Tell your story loud and long, here and elsewhere. Join with other victims' families to get laws passed to reduce hospital infection rates.

Read more in articles by Robert Kittle and David Hutchins.