Grouping MRSA positive patients together in the hospital

Question

Hello,

Due to outpatient surgery not related to my CF, I was supposed to be separated from other patients and be prepared in an isolation room of a ward.

There was another MRSA patient in that room. According to the nurse, “nothing could happen,” since that patient only had the MRSA in her blood.

I vehemently refused to be put into that room and the problem was solved in another way.

After consulting my CF clinic, I learned that this approach is indeed common and that hospitals do not distinguish between different strains. Their stance: “MRSA is MRSA.” I disagree and, according to my current state of knowledge, think that MRSA is not at all the same as MRSA.

My question now: There can either be transmission, but then even we MRSA patients are putting each other at risk; or there can NOT be transmission, then the whole idea of isolation does not make sense. How can such schizophrenic instructions come about?

Answer

Dear questioner,

This is an interesting question! You are right with your assessment! If possible, MRSA-positive patients should be accommodated separately as well. After all, MRSA could indeed be transmitted among patients. The only exception is in case the MRSA clone is already known. Sometimes the clone can be determined within just a few days by way of molecular typing, where the DNA of the germ is isolated and certain areas are sequenced (e.g. the so-called “spa typing,” a sequencing of a particular region of a Staphylococcus aureus protein). Patients with the same clone could then indeed be treated together in one room. Unfortunately, it is often not possible to get this information quickly. Also, for logistical reasons, hospitals often are not able to treat MRSA patients in single rooms due to a shortage in beds.

Kind regards
Barbara Kahl

14.08.2012