On February 3 the Queen Elizabeth Hospital in Charlottetown, PEI realized it had a MRSA outbreak on its hands. Over the ensuing days seven patients in one ward, a medical nursing unit, tested positive for the pathogen, one of whom became infected.
In response, the affected patients were isolated from other patients, received treatment to destroy the MRSA, and their new rooms were subject to enhanced cleaning and infection control protocols such as the mandatory wearing of gowns, gloves and masks by staff who interact with them.
Visitors to the affected patients were restricted to 2 members of the immediate family for only 15 minutes. All visitors to the hospital are warned to clean their hands before and after entering a patients’ room, a ward, and upon entering and leaving the hospital.
Dr. Rosemary Henderson, Medical Director of the QEH, told me in a telephone conversation yesterday that everything now seems under control as every hospital patient has tested negative for the past 2 weeks. One more week of testing and they will be confident that the problem has been solved. And the patient who became infected is now fine and has been discharged from the hospital.
The previous MRSA outbreak at QEH happened this past July when 10 patients in a general medical unit tested positive for MRSA.
Before that, in November 2008, 9 babies in the nursery unit and one of their mothers tested positive for MRSA. Because this was a more serious outbreak, in addition to the standard precautions mentioned above, any staff member who had contact with the nursery was tested – doctors, nurses, cleaners, dieticians … anybody.
This caused a lot of stress at the hospital. The local newspaper reported that staff felt as if they were living under a microscope and were afraid of being blamed for the outbreak and were even afraid of being fired.
And it appears there was yet another outbreak that year prior to November. Rick Adams, CEO of the QEH, said at the time “We’ve had a tough year no doubt about it. We had our battles this year with MRSA and VRE (vancomycin-resistant enterococci) in some of the other units and now this.”
But this story is not about the QEH per se. Here’s what’s crucial to understand: the QEH is just like any other hospital with its history of MRSA. The QEH case simply illustrates the serious nature of the MRSA problem in hospitals across the country.
1 in 12 adults in Canadian Hospitals are colonized or infected with MRSA (the biggest offender, representing 67% of the total), VRE or C difficile, according to a study published last summer by a team of Canadian infectious disease experts.
Second, the rates of health care-associated infections caused by MRSA, which can cause life-threatening pneumonia, plus wound and blood infections, “increased more than 1,000% from 1995 to 2009” (the last year for which numbers are available), says Canada’s Chief Public Health Officer, Dr. David Butler-Jones, in his 2013 Report on the State of Public Health in Canada.
One of the main reasons for this serious state of affairs is extraordinarily counter-intuitive: it is that the hospital is an inherently dangerous place.
“I do think that people need to understand that the hospital is an inherently dangerous place and it’s not because hospitals are dirty or doctors are lazy or anything like that. Think about it this way. You’re taking the sickest people in society, crowding them into one building, tearing new holes in their bodies that they didn’t use to have by placing plastic catheters in their bloodstream, their bladder, putting tubes into their lungs that can breathe for them, and we’re using very large quantities of antibiotics to treat infections. So that’s a perfect breeding ground to generate antibiotic resistant bacteria [like MRSA].”