Bug Puts Hospitals On Edge, On Guard

Floyd Rodgers landed in Washington Hospital Center in March when what he thought was an insect bite on his face became ugly and tight. The 46-year-old District man, who shares a bathroom with others in his apartment building, suspects he picked up the infection from a razor or towel someone else had used.

He remained in isolation for much of his 11-day stay as doctors tried different antibiotics. "It was real big, like a fist," Rodgers recounted. "It was hard to swallow." The specialist brought in on his case, Krishna Dass, said Rodgers could have risked septic shock had he delayed seeking help.

"MRSA keeps getting worse," Dass said. Washington Hospital Center now does routine screening and cultures of patients with conditions that could make them more vulnerable to the bug.

City officials first asked District facilities to report their incidence of cases last year; the task force could recommend mandatory reporting. Some members are urging a major public health campaign.

"Every hospital . . . out there is grappling with how to handle this," noted Keri Hall, an epidemiologist at the University of Virginia Medical Center, which produced a video to explain to MRSA-positive patients why strict gown-and-glove precautions should be taken whenever anyone, from a relative to a surgeon to a housekeeper, enters their room.

Virtually no U.S. health-care facilities have taken measures as stringent as those in a few European countries. They have largely defeated MRSA by testing and isolation so widespread that it has been dubbed "search and destroy."

But some, like the University of Maryland Medical Center, are moving in that direction. Compared with Virginia and the District, Maryland has the most comprehensive anti-MRSA efforts underway. Seven Maryland hospitals are part of a national project to encourage novel yet common-sense approaches to block the bacterium.

At Johns Hopkins Hospital, STOMP -- for Stop Transmission of MRSA Permanently -- became the mantra in September. The campaign updates staff with weekly numbers of possible transmissions. It emphasizes hygiene by ensuring that alcohol-based hand gels are never out of reach in a patient's room.

Franklin Square Hospital Center, one of the first project sites, emphasizes the use of disposable gowns and gloves for any staff members entering isolation rooms. The hospital goes through 24,000 gowns every quarter -- five times its previous volume.

What's being learned will filter soon to more facilities, thanks to the Maryland Patient Safety Center. The center, a collaboration of the state hospital association and the national Delmarva Foundation, also hopes to have training in community clinics and doctor's offices.

"This particular problem touches everyone," said Margaret Toth, the foundation's chief quality officer. "If we're to address it only as a hospital issue, we'll make no dent."