Staph Infections And MRSA: Passive Attitude Of Physicians Is Causing Harm To Patients!
Staph And MRSA Infections Are Increasing! Why?
Staph infections and MRSA infections are on the rise. Every year, they become more and more common. These infections can be very serious, even causing death. A recent experience has led me to believe that the nonchalant attitude displayed by many physicians is contributing to the increase and spread of both infections. To help you understand this conclusion, explanations of the infections are necessary, but first let me tell you a little bit of the personal side.
My best friend is a mental health social worker in a Southern California county women's jail facility. She works with the sickest of the sick. It is not uncommon for her to encounter young women, so seriously disturbed, that they eat their own feces. In her position, she is often faced with hopeless situations, women who may never be helped. While speaking to her on the phone, she explained that her neck was killing her. I was aware that she had been feeling ill for several days, and then she told me she thought there was a bite or sting of some sort on the back of her neck. A member of her family had looked at it and told her that it appeared to be filled with pus. Because I have had repeated experience with staph and have had MRSA, I was immediately alarmed. I knew that it sounded like a staph infection, maybe even MRSA.
I know the facility my friend works in has a continuing problem with MRSA; a problem so pervasive that when she was hired, she was forced to sign a confidentiality statement promising to never disclose to media that the problem was severe or ongoing. There are signs throughout the facility warning of MRSA. In spite of the facility's awareness that MRSA is rampant, anti-bacterial gel has not been made readily available. Containers that are supposed to hold the gel are often empty for weeks, and employees are instructed to buy their own gel and wipes for use while at work.
I told her to google staph and look at some of the pictures and then to call her 24 hour insurance nurse advisor. The back of her neck looked just like the pictures and the nurse advisor told her to get to a hospital within the hour, which she did.
She was seen at Marina del Ray Hospital by the ER doc who was on call that night. He is certified in emergency medicine and has no malpractice cases pending. The hospital she went to has a decent reputation. The doctor incised the abscess and drained it. When my friend asked him to culture it, the doctor said there was no need; he knew that it was staph. He prescribed 2 antibiotics, and she was on her way. She was given no follow-up instructions, but was given 2 days off work. A review of the chart shows no mention of staph. Since that visit, she has had to see two additional doctors. The second physician took cultures, and even though he also believed the abscess was staph, told her to have someone in her family squeeze the abscess to get more liquid out of it. That's right! In the absence of a definitive diagnosis and the probability that the abscess was staph, expose members of the family! Great advice! The first culture has come back as staph and the MRSA results will be back by next week. She finished her course of antibiotics, with limited improvement. The third physician, a work comp doctor, has started her on a second, different course of antibiotics because the first course was ineffective. Not only was the first course ineffective, the original prescription only provided a 7 day dose, which according to the third physician, should have been prescribed as a 10 day regimen. Errors all around! I feel that this is just the beginning of what may be a long and difficult journey for my dear friend. Staph, once it has invaded, has a nasty habit of rarely leaving, only to return, time and time again. These infections can last for years.
The first physician, despite telling my friend that she had a staph infection, refused to take a culture, did not record that diagnosis in the medical record and prescribed incorrect antibiotics. The second doctor, knowing that it was staph, took a culture, but advised her to expose her family members to this highly contagious infection.
From MedicineNet.com, A Staph infection is: "Staphylococcus is a group of bacteria that can cause a number of diseases as a result of infection of various tissues of the body. Staphylococcus is more familiarly known as Staph (pronounced "staff"). Staph-related illness can range from mild and requiring no treatment to severe and potentially fatal." Most of these infections are caused by an organism called staph aureus. These infections are contagious and usually manifest themselves through abscesses, boils or furuncles. Pus is usually present. When staph enters the blood stream, it can cause sepsis and organ failure, which can be fatal. Almost all literature concerning staph infections recommends that physicians take a culture and determine the nature of the infection. Treatment for staph is most generally an antibiotic ointment applied topically and a broad-spectrum oral antibiotic. Culture of the site is part of the accepted standard of care.
MRSA, or antibiotic resistant staph aureus, can be difficult to treat and is highly contagious. From MedicineNet.com: "MRSA infections are usually mild superficial infections of the skin that can be treated successfully with proper skin care and antibiotics. MRSA, however, can be difficult to treat and can progress to life-threatening blood or bone infections because there are fewer effective antibiotics available for treatment." Culture of the site is part of the accepted standard of care.
Staph and MRSA are infections that can be caught by anyone. MRSA, up until recently, was rarely found outside of hospitals, prisons, or where large populations were held in crowded, sometimes unsanitary conditions. Now, however, they have become more community-based infections and MRSA is found almost everywhere, including schools, gyms and locker rooms, even grocery stores. Left untreated, or improperly treated, MRSA mortality rates can be very high. Pediatric cases of MRSA are on the rise, with toddlers and young children, and the bacteria is now invading their ears, noses and throats in record numbers.
The infections have become so prevalent that many states have found it necessary to include staph and MRSA as work-related illnesses. In those states, if you are a hospital, health care worker or prison employee, staph and MRSA are automatically presumed to be illnesses contracted in the workplace and you are compensated for your illness and entitled to medical care.
Why Is The Standard Of Care Being Ignored?
A diagnostic and treatment process that a physician should follow for a certain type of patient, illness, or clinical circumstance is called the standard of care. For each set of symptoms and conditions, there are procedures that prudent physicians should follow. So, in the case of suspected staph or MRSA, almost every piece of literature stresses the necessity of obtaining a culture. A culture is the only way to determine staph aureus or MRSA infection on the skin or in a lesion. In the absence of a culture or blood work, there can be no definitive diagnosis, and therefore, it is possible to treat the patient with an ineffective medication. If the medication is ineffective, the patient's condition can become worse, and in the worst of cases, the patient can die.
I would not want to be the patient of a doctor who, when presented with an infection that he believes may be staph, refuses to take a culture. I would not recommend that physician to a friend or family member, and I would refuse to pay a bill from a doctor who fails to provide me with an official diagnosis because he does not comply with the accepted standard of care.
Why would a physician refuse to culture a lesion that he encounters? Why would a physician skip running a simple test? Laziness? Incompetence? Rushed?
New Rapid Diagnostic Test Just Approved!
- Staph Infection Battle Adds New Rapid Diagnostic Test | Health News
Last Friday, the FDA cleared a diagnostic test that will be able to quickly determine staph infections and their resistance to antibiotics.
- Standard of care for MRSA infections - The Clinical Advisor
ClinicalAdvisor.com provides a forum in which primary-care NPs and PAs can have their clinical questions answered by experts.
The Possible Consequences Of Sloppy Medical Care!
Everyone knows what can happen if the medical care you are provided turns out to be sloppy. The resulting damage can be life-lasting or even life-ending. With the ever increasing incidence of staph and MRSA in this country, there is no excuse for ignorance or laziness on the part of the medical community. Ignorance or negligence is inexcusable in relation to these two diseases. There is too much information readily available regarding the treatment of staph and MRSA. The diseases are no longer rare and every physician should be responsible enough to educate themselves. Doctors do make mistakes, but the pattern of treatment experienced by my friend was not a mistake. The pattern of treatment she has received may fall short of malpractice, but it is far from what would demonstrate best practice. Finally, the pattern of care received does nothing to convince me that the medical community is taking this illness seriously.