Dear Editor,

Recently in the news we have read about the “passing” of a few persons who were patients at the Princess Margaret Hospital. Whilst the causes of death published could in fact be the real reason of those deaths; I have a concern here and that is MRSA or “The Super Bug” as it’s sometimes called is or have been or could be one of the many reasons for some of those untimely deaths of some of these patients.

“Methicillin-resistant Staphylococcus Aureus (MRSA) is a type of staph bacteria that is resistant to certain antibiotics called beta-lactams. These antibiotics include methicillin and other more common antibiotics such as oxacillin, penicillin, and amoxicillin. In the community, most MRSA infections are skin infections. More severe or potentially life-threatening MRSA infections occur most frequently among patients in healthcare settings. While 25% to 30% of people are colonized* in the nose with staph, less than 2% are colonized with MRSA (Gorwitz RJ et al. Journal of Infectious Diseases. 2008:197:1226-34.)”

*Colonized:

When a person carries the organism/bacteria but shows no clinical signs or symptoms of infection. For Staph aureus the most common body site colonized is the nose.

Nursing staff may not be aware of it at the time and just go with an explanation of whatever the patients condition is at the time. Having worked in such an environment in a foreign country for many years; it is cause for concern these sudden vaguely explained deaths. Medical staff tend to just give obvious reasons and never look further. Nurses may give the patient an antibiotic that could escalate the spread of the bacteria. I do not wish to give the impression that the nursing and medical hygiene practices at the PMH is anything less than thorough; but as human beings we tend to get comfortable in our environments and not be aware of our transmitting of the bacteria or that we should maintain the highest care standards as possible at all time.

I would hope that the Medical Board and Ministry of Health would revisit this area and check because this “super bug” can be the cause of the increase in patients untimely deaths at the PMH and not the operation they did. They could have an allergic reaction to some of those medication that is supposed to also help fight this bug.

You go in to hospital most times without this bug and leave with it. And it’s most prevalent in the older patients.

“Symptoms of MRSA

As with all regular staph infections, recognizing the signs and receiving treatment for MRSA skin infections in the early stages reduces the chances of the infection becoming severe.

Severe Infections

MRSA in healthcare settings usually causes more severe and potentially life-threatening infections, such as bloodstream infections, surgical site infections, or pneumonia. The signs and symptoms will vary by the type and stage of the infection.

People at Risk of Acquiring MRSA Infections

MRSA infections can occur in any geographic location and anywhere on a person’s body and can affect anyone. Historically, MRSA infections occurred in hospitalized patients, but now these infections are common in the community. The biggest risk factor for MRSA infection is open or broken skin (such as a wound or surgical site); however, MRSA infections can occur even on areas of the skin where there is no obvious wound or break in the skin.

Patients in Healthcare Settings

Patients in healthcare facilities have weakened immune systems and undergo procedures (such as surgery) or have catheters inserted into the skin that make it easier for MRSA to get into the body. It is for this reason that healthcare personnel must follow infection control procedures (such as hand hygiene and proper catheter care) to prevent patients from acquiring MRSA infections. When patients get MRSA in healthcare facilities, the infections tend to be severe. Common infections include surgical wound infections, urinary tract infections, bloodstream infections, and pneumonia.

Visitors of Infected Patients

When visiting MRSA patients, individuals should follow the facility’s visitor policies. Casual contact—such as kissing, hugging, and touching—is usually acceptable. Visitors should avoid touching catheters or wound sites and should wash their hands before leaving an infected person’s room.

I am hoping that some medical professional at the Hospital or the Ministry of Health would take a closer look at the increase in deaths at the PMH most especially for those who have been there for less than three days or a week.

We need to quickly enlighten staff and visitors alike of this bug and our hygiene practices at the Hospital. Persons from the community tend to be hostile towards staff when they are informed of the Ward rules but with much publicity of this “super bug” they may exercise different behavior.

Visitors should be made to wash their hands thoroughly before entering any ward to visit a patient or given hand sanitizer on entering the wards to help reduce the spread of the bug. Nursing staff and ward aids should at best always wash their hands before attending to the next patient. In Dominica we have this patois slang saying (tou pwase paka fais jous overt)”patois spelling may not be correct, but you get the idea – ” too busy doesn’t bring daylight quicker”.

There are numerous research sites on the internet to enlighten about this bug and persons should make it their business to know about this bug.