Frequently Asked Questions and Answers for Patients and Families regarding MRSA and Infection Control at BIDMC
What is MRSA?
Methicillin Resistant Staphylococcus Aureus or MRSA, is a type of bacteria that is resistant to certain antibiotics. These bacteria most typically cause skin infections. A person can either be infected or colonized with MRSA. When a person is infected, the bacteria produce symptoms. A person colonized also has the bacteria, but it may not cause any symptoms. As background, it is important for you to know that bacteria are naturally present on all human bodies, including those of newborn infants. Although most bacteria generally do not pose a threat for healthy people, some may result in treatable skin infections and some bacteria could be a problem for people who are very sick or who have weakened immune systems. Healthy individuals, infants and adults alike, will typically clear bacteria from their bodies over time.
There are two types of MRSA bacteria: those that are found most commonly in hospitals and those that are found most commonly in the community. For general information on MRSA visit www.bidmc.org, choose “Your Health” on the right, then “Conditions A-Z.” Under “M,” you will find information about MRSA.
What is Occurring at BIDMC?
- Between last November and March, a small number of mothers and/or newborns were treated for MRSA infections after being discharged from Beth Israel Deaconess Medical Center.
- To date, BIDMC mothers and babies impacted have been treated for skin infections (most of them minor) and, in mothers, for breast infections. A few have required readmission for treatment of the infection.
- While we are extremely concerned about these recent infections with MRSA, the cases of infection in this cluster represent a small percentage of the nearly 5,000 births that take place at BIDMC every year.
- These recent occurrences at BIDMC have been tested and found to be the most common type of “community-associated” MRSA, meaning the origin of the bacteria is most likely outside of BIDMC, but we have not yet been able to determine how it has spread. There have been periods of as long as several weeks with no infections, followed by a reappearance.
- In the course of investigating these clusters of MRSA, state agency officials observed several instances when BIDMC staff infection control practices did not meet BIDMC’s own standards or those of outside agencies.
What is BIDMC doing about this?
- We are aggressively investigating whether hospital-based factors may be contributing to the MRSA clusters. These infections have been reported to city, state and federal agencies, and we continue to work closely with them.
- Other initiatives have included extensive evaluation of the physical environment, development of new cleaning protocols, reinforcement of existing infection control policies and the creation of rigorous new infection control measures.
- There has been a complete review of our infection control practices on Labor and Delivery, our Postpartum Units, and our nurseries, and extensive improvements have been made. Among other measures, we have revised our process for cleansing the skin for Cesarean delivery, have re-educated the entire staff regarding prevention of infection (and MRSA in particular), instituted a policy that gloves will be worn in the nursery for any care provided to a baby and we have made aggressive changes to our circumcision procedures to assure the strictest adherence to sterile technique.
- Hospital-wide, all staff who have contact with patients are in the process of taking a additional mandatory infection control training by May 1 to ensure all are aware of and adhering to BIDMC’s standards of care.
We are confident that our efforts will make BIDMC an even safer place, and we will continue to provide our patients with the best possible medical care.
Should I Worry about MRSA or Other Infections at BIDMC?
BIDMC strives to provide the safest and highest quality care possible and has a very robust quality and safety program, which is reflected in multiple national and local measurements.
- While these clusters of MRSA infections in one area of the hospital have been challenging, similar occurrences of this infection have not been found to be associated with any other area of the medical center, including our neonatal intensive care unit (NICU).
- In fact, hospital-acquired MRSA infections have been decreasing at BIDMC even as this type of bacteria has grown more prevalent in the community.
- BIDMC has a strong infection control history, including impressive reductions in the most serious types of healthcare-acquired infections, including bloodstream infections in association with central lines and ventilator-associated pneumonia.
- BIDMC successes include documented, steady improvement in hand hygiene practices through concentrated education and measurement efforts.
What can I do Protect Myself and My Family?
BIDMC encourages patients and family members to “Go Ahead and Ask.” That means if you or a family member is in the hospital, you should feel comfortable asking any of your caregivers at any time if they have cleaned their hands. We welcome your asking and appreciate the additional reminder.
As MRSA and other infections can be spread from person to person, good hand hygiene is the best thing that parents and family members can do to decrease their risk of spreading them.
Clean your hands often. Especially important times include:
- Before, during and after you prepare food
- Before you eat
- After you use the bathroom
- After you change a diaper
- After handling animals or animal waste
- When your hands are dirty
- More frequently when someone in your home is sick
To properly wash your hands, follow these simple steps:
- First wet your hands with warm water and apply liquid or lather with a bar of soap.
- Next rub your hands together vigorously and scrub all surfaces. Also clean under your fingernails to help control germs and keep them trimmed and short.
- Continue for at least 15 seconds or about the length of a little tune (for example: the "Happy Birthday" song). It is the soap combined with the scrubbing action that helps dislodge and remove germs.
- Rinse your hands well and then dry them.
Note: Alcohol-based hand rubs offer a quick and easy alternative to soap. No water is needed and studies show they are very effective. But hand washing with soap and water should be performed if your hands are visibly soiled, such as after using the restroom or changing a diaper.
In addition:
- Keep cuts and wounds clean and covered until healed.
- Avoid contact with other people’s wounds and materials contaminated by wounds.
