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MRSA infections kill more than 18,000 people a year, and six out of seven people infected with the antibiotic-resistant germ contract it at a health care facility. The germ, methicillin-resistant Staphylococcus aureus, spreads by touch or contact, and can enter breaks in the skin as small as a mosquito bite. It can cause painful and treatable skin lesions or slip into the blood; one percent of infections are fatal, and many others result in crippling injuries.

MRSA is typically carried on the skin. Researchers have previously estimated that 1 to 2 percent of the population carries the germ, but Washington hospitals that instituted selective screening found that up to 11 percent of people carried the germ on their skin.

Last fall, the Centers for Disease Control and Prevention announced the astonishing number of deaths caused by MRSA each year. In the past ten years in Washington, hospital patients infected with MRSA jumped from 141 per year to 4,723. However, the hospitals don’t track the germ or infected patients, nor do they have to reveal infection rates. The Seattle Times analyzed documents, including hospital records and death certificates, and found 672 previously unreported deaths caused by MRSA.

Screening for MRSA is quick and painless, only costing about $20, but no community hospital in Washington screens every patient for the germ. Federal veterans’ hospitals screen all patients, and have reduced their cases to almost zero. But the Washington hospitals claim that testing is unnecessary, and that washing hands and wearing protective garments is enough to prevent MRSA from spreading. However, the hospitals claiming these infection control measures are enough are failing to use them, even when state and federal inspectors are around. State records show that seven staff members at one hospital were cited for violating basic infection-control standards during a four-day inspection in 2007, even after advanced notice of the inspection. In fact, most of the state’s 25 largest hospitals have been cited for unsanitary conditions or failure to adhere to fundamental safety standards, according to state and federal regulatory reports dating back to 2005.

In Washington, there are no state or federal mandates for screening patients for MRSA. While cardiac patients, critically ill patients, and patients with weakened immune systems are among the most vulnerable to infections, there is no set screening policy among hospitals. One hospital may test intensive-care unit patients but not those having elective surgery, while another tests patients having elective surgery but not patients in its ICU. The Seattle Times found that in Washington’s 25 largest hospitals, most patients don’t get tested. Those who oppose testing all patients argue that hospitals lack the staff, resources, and space for testing or isolation of patients with MRSA. In addition, they say screening could result in lawsuits where patients picked up MRSA in the hospital after a negative screening upon admission.

The number of deaths caused by MRSA is unknown because of missing information in public health records. When filling out death certificate forms in Washington, physicians are asked to state not only the primary cause of death, but also the chain of events contributing to death. The Seattle Times found multiple instances where an autopsy or medical record showed MRSA, but the death certificate omitted it completely. In addition, an old database of death certificates released by the Washington Department of Health excluded information regarding doctors’ notes, and used an international standardized coding system with more than 13,000 diagnosis codes, none of which are for MRSA. The Seattle Times requested a complete database this year, and found 672 deaths linked to MRSA from 2003 to 2006; the old database did not link any deaths to MRSA.

Nationally, exact numbers of deaths attributed to MRSA are also unavailable, leading to the question Chuck Velte, whose mother died from MRSA, asked: “How many people die of MRSA and nobody ever knows?”

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