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Kuakini Prepared for MRSA since 1990

Kuakini uses a sensitivity plate like this one to determine if a bacteria is sensitive or resistant to antibiotics. The bacteria (in yellow) is spread over the entire plate and various antibiotic disks (12 lettered dots) are inserted to test the bacteria. In this particular case, only the Vanco-mycin disk (the far left dot labeled VA30) was effective against this MRSA strain, as indicated by the distinct area of clearing around it.

Methicillin-Resistant Staphylococcus aureus (MRSA) is an antibiotic resistant form of the bacterium Staphylococcus aureus (S.aureus) which commonly lives in the noses and on the skin of healthy people and spreads from person to person on contaminated hands, skin, and objects. Most infections caused by MRSA are skin infections, but the germ can also cause more serious infections such as blood and joint infections, and pneumonia.

MRSA recently received nationwide attention after a Centers for Disease Control (CDC) study published in the October 17 issue of the Journal of the American Medical Association found that more people in the U.S. die of MRSA than AIDS. (In 2005, 18,650 died of MRSA compared to about 16,000 from AIDS).

Also cases of infection identified among students from around the country resulted in temporary closings of schools for disinfection. Fitness gyms and athletic programs from the high school to professional level are examining and intensifying their infection control procedures. While community-acquired MRSA is on the rise, the most common MRSA strains can be traced to health care facilities.

Kuakini Health System has been a leader in MRSA prevention since 1990. Six years before the CDC issued its first MRSA guidelines, Kuakini Medical Center implemented a comprehensive MRSA policy that included education and training of health care workers, intensive surveillance for the presence of MRSA in patients, and extensive isolation infection control measures that required isolation of patients with MRSA from others. In the mid-1990s, Kuakini Geriatric Care, Inc. revised its MRSA policy in accordance with Hawaii State Department of Health guidelines specific for long-term care facilities.

Since 1990, Kuakini’s Infection Control Coordinator has investigated every case of MRSA found at Kuakini to identify the source of the bacteria. Results of laboratory tests are used to identify individual strains. This information helps Kuakini implement appropriate actions and monitor the effectiveness of its program in preventing the spread of MRSA among its patients and residents.

Isolation is an infection control measure used to prevent the spread of MRSA at Kuakini. MRSA patients are placed in single-patient rooms which are cleaned and disinfected frequently. Caregivers use personal protective equipment including gloves, gowns, masks and eyewear when treating MRSA patients.

Kuakini Health System took MRSA seriously from the beginning and has been vigilant in investigating all MRSA cases long before the federal and state agencies addressed this situation and long before European countries addressed MRSA. Aggressive infection control measures were taken, including promoting hand washing and isolating MRSA patients when it was not yet a community standard. All patients and residents can possibly carry MRSA. So, blood pressure cuffs, or any other piece of equipment that touches a patient are either disposed or cleaned routinely.

Despite heightened public awareness of MRSA, it is very difficult to eradicate the bacteria from schools and public facilities. An estimated 95 million healthy Americans currently carry the S. aureus bacteria on their skin or in their noses, and  2.5 million Americans carry MRSA, the antibiotic resistant form of S. aureus.

Although healthy people are constantly exposed to bacteria like MRSA, they will not get an infection unless a sufficient amount of the bacteria enters their body and overwhelms their immune system. By keeping things clean and reducing the number of germs, individuals can prevent infections from occurring. Kuakini Health Care Team members are extra careful because they provide care to the patients and residents with weakened immune systems such as older adults, surgical patients, and patients receiving chemotherapy drugs.

Some MRSA Prevention Tips

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