New Jersey mandates screening for deadly infections

While recovering from the injuries he sustained in an early spring car accident, New Jersey Gov. Jon Corzine noticed how hard the staff at Cooper University Hospital in Camden, N.J., worked to prevent the spread of infection.

During his recuperation, Corzine wondered whether other hospitals in the state worked as aggressively to prevent infections. But there was no way for him to find out-New Jersey does not keep track of hospital-acquired infections, and the programs hospitals have in place to prevent these infections vary depending on the institution.

For example, some hospitals, such as Overlook Hospital in Summit, N.J., and Newark Beth Israel Medical Center screen patients for methicillin-resistant Staphylococcus aureus, a potentially deadly bacteria more commonly known as MRSA. Others, such as Jersey Shore University Medical Center in Neptune, N.J., isolate high-risk patients but don't screen for MRSA.

Corzine agreed. Last month, the Governor signed legislation that requires hospitals to test intensive care patients for MRSA and report all cases to the N.J. Department of Health & Senior Services. The new law, which took effect earlier this month, also requires hospitals to test patients for MRSA upon admission and discharge to prevent the spread of the disease.

Corzine's renewed focus on the prevention and treatment of staph infections will help increase awareness of the disease among hospitals and pharmacists, said Andre Emont, pharmacy director at the University of Medicine and Dentistry of New Jersey (UMDNJ) and president-elect of the New Jersey Society of Health-System Pharmacists. "I think what it's going to do is bring awareness in making sure that the right antibiotic is being chosen," he noted. "It's prescribing efficaciously. It's a safety issue-we're running out of antibiotics, and we don't want resistant superbugs. When something like this gets brought to the forefront, it's going to result in increased awareness and action."

Focusing on preventing MRSA could potentially save hospitals in New Jersey millions of dollars each year in treatment costs. Nationally, hospital infections kill more than 100,000 Americans annually and cost about $7.5 billion to treat. "It's a growing concern, but we're not sure how big of an issue this is in hospitals because we have no data," Holmes explained. "It's not something that's required to be reported in New Jersey."

Statistics from the Centers for Disease Control & Prevention, however, indicate MRSA is running rampant in the nation's hospitals. In 1974, MRSA comprised 2% of staph infections at hospitals; in 2004, it accounted for 63%, according to CDC figures. And a study released in June by the Association for Professionals in Infection Control & Epidemiology found that the prevalence of MRSA in American hospitals is eight and a half times greater than originally thought.

Holmes estimated that one-third of the NJHA's member hospitals started screening patients for MRSA well before Corzine signed the new law on Aug. 2. Epidemiologists at Somerset Medical Center in Somerville, N.J., said the hospital implemented MRSA screening for all critical care unit patients in 2004. The facility also employs two full-time certified infection control practitioners and a full-time physician epidemiologist, and it participates in programs to reduce high-risk or high-frequency infections. As a result, the number of MRSA bloodstream infections in critical care unit patients went from 10 in 2004 to zero last year.

MRSA-related infections are nearly nonexistent at Jersey Shore University Medical Center, which began isolating high-risk patients about five years ago, said Peg Janasie, manager of infection prevention and control at the hospital. "We've had some pretty good measures in place for years," she said. "Anyone in ICU is considered high-risk. We're doing the isolation part of [the law], the only thing we have to do is the screening. The new law is not really going to change our [prevention] practice."