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Buono Measure Would Help Knock Out Drug-Resistant Germs

TRENTON – Saying that, “A few very basic safeguards can save the State millions of dollars in health care costs,” Senator Barbara Buono today welcomed Senate Health, Human Services and Senior Citizens Committee approval of her bill to require hospitals to implement more stringent infection prevention programs targeted at limiting the number of Methicillin-resistant Staphylococcus aureus (MRSA) infections.

According to Centers for Disease Control (CDC) reports, two million patients in this country become infected after entering hospitals each year and about 90,000 those patients die as a result of those infections. Those reports also point to MRSA becoming the dominant cause of hospital staph infections over the past three decades, rising from 2% of all reported cases in 1974 to more than 63% of all cases in the United States.

“For years it has been assumed that certain rates of infections were considered unavoidable,” said Senator Buono, D-Middlesex. “Now hospitals are finding they can dramatically reduce and ultimately eliminate killer infections by changing how they do things.”

Senator Buono pointed to an MRSA control program undertaken by the Department of Veterans Affairs (VA) Pittsburgh Healthcare System that reduced infections in one of its surgical care units by 70% as the inspiration for her bill, S-2580.

Every patient hospitalized in the VA Pittsburgh Healthcare System has a nasal swab taken once on admission and once on discharge to test for MRSA. Because of the program’s success, the Veterans Health Administration issued a directive for all VA health care facilities to implement similar plans to prevent the transmission of MRSA. Each infection can cost a hospital tens of thousands of dollars.

The VA directive calls upon all VA health care facilities to begin testing for MRSA in the intensive care units, as these are usually settings where the presence of MRSA can be problematic resulting in increased patient morbidity and mortality. Patients with MRSA are to be isolated to help break the chain of transmission. Expansion of this initiative to other inpatient sites where there is significant risk of MRSA infections will progress until all inpatient areas are incorporated into the MRSA initiative.

According to Dr. Rajiv Jain, Pittsburgh Healthcare System’s Acting Director and Chief of Staff, identifying, isolating and treating MRSA carriers is standard procedure in Denmark, Finland and the Netherlands, countries that have managed to suppress MRSA’s spread almost entirely. Dr. Jain is heading the national effort to roll out screening programs throughout the VA system.

“The VA initiative is a sensible, cost effective means of infection control and the type of practice our hospitals need to enact here in New Jersey,” said Senator Buono. “The legislation is modeled after this successful program which cut infections by more than 70%.”

Senator Buono’s bill will call for a comprehensive approach which will require hospitals to incorporate the following strategies:

* identification and isolation of patients with MRSA

* patient cultures for MRSA upon discharge from the units where the infection prevention program has been implemented

* strict adherence to hygiene guidelines

* a written infections prevention and control policy with input from frontline caregivers

* a worker education requirement regarding modes of MRSA transmission, use of protective equipment, disinfection policies and procedures, and other preventive measures

Senator Buono noted that MRSA can do significant harm, particularly to individuals whose immune systems are compromised by fighting off other medical conditions. It can prove difficult to treat given its resistant to so many types of antibiotics.

According to an article published in the Lancet, one of the oldest peer-reviewed medical journals in the world, on September 2, 2006, the costs of caring for patients who become infected with MRSA are much greater than the costs of screening programs. It is estimated that the treatment of patients infected by MRSA is costing the United States over $4 billion a year.

“The treatment of patients infected by MRSA is costing the United States too much money and too many lives,” said Senator Buono. “We can improve the health and safety of patients while also saving money.”

The bill passed the committee by a vote of 9-0 and now goes to the full Senate for their approval.

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