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Illinois will become the first state to screen hospital
patients for dangerous drug-resistant staph infections under legislation signed
by the governor on Monday.
The new law puts Illinois at the forefront of
efforts to battle methicillin-resistant staphylococcus aureus (MRSA) infections,
which strike more than 1 million patients and kill tens of thousands of people
each year.
With its passage, Illinois leads the nation in addressing
MRSA, the most common type of hospital-acquired infection, said Pat
Merryweather, senior vice president at the Illinois Hospital
Association.
Pennsylvania and New Jersey both enacted similar laws this
year, but their laws will be implemented later. Illinois' new law, Senate Bill
233, becomes effective immediately.
It calls for hospitals to test all
patients in hospital intensive-care units for MRSA infections and to isolate
patients with the bacteria so they won't pass it on to others. Medical providers
will be required to wash hands and to wear masks and gloves when dealing with
infected patients.
Although several European nations mandate similar
measures to combat MRSA, they're not yet accepted practice in the U.S. The
Illinois bill was highly controversial.
It sat for well over a month on
Gov. Rod Blagojevich's desk while a group of hospital infection-control
practitioners lobbied vigorously against the measure. They claimed it would
interfere with their ability to respond flexibility to emerging threats, such as
Clostridium difficile and Vancomycin-resistant enterococci, also dangerous
superbugs.
Instead, the infection-control providers advanced a competing
piece of legislation, HB192, requiring hospitals to analyze which infections
posed the greatest risks in their institutions and come up with plans to prevent
their spread. They argued the approach was both less prescriptive and more
comprehensive.
Supporters of mandatory screening for MRSA countered that
what was needed wasn't further studies but strong action. The only proven way to
reduce infections is to test patients, isolate those who are positive, and
institute hygienic measures meant to control the bacteria's spread, they
argued.
Until midday Monday, it wasn't clear what the governor would do.
In the end, he surprised both camps by signing both pieces of legislation. But
in a press release, the governor commented only on HB192.
"People should
feel confident that when they go to a hospital, a nursing home or other health
facility for medical care, they will not end up worse off with a dangerous
infection. This bill will help make sure facilities are safe and clean and will
help reduce the risk of infections," Blagojevich said.
Reaction was,
predictably, mixed.
Jeanine Thomas, an advocate who has devoted the last
two years to advancing mandatory screening for MRSA, was beside herself with
excitement. "This is fantastic; it's going to save so many lives," said Thomas,
who contracted MRSA in 2000 in a Chicago hospital.
Michael Vernon,
president of the metro Chicago chapter of the Association of Professionals in
Infection Control & Epidemiology, couldn't hide his
disappointment.
"Oh my goodness. I'm shocked," he said, upon learning of
the governor's move from a reporter. "I think this will pose a significant
problem for hospitals trying to implement these two bills."
The
administration's position now appears to be that the varied approaches embodied
in the two pieces of legislation are complementary.
"They're both aimed
at protecting patients," said Dr. Craig Conover, medical director of the office
of health protection for the Illinois Department of Public Health. The MRSA law
is more focused and action-oriented, while the other legislation is more
comprehensive and will attack a wider variety of pathogens, he said.
Both
laws will yield far more robust information about drug-resistant infections
circulating in Illinois hospitals. They call for yearly reports on MRSA and C.
difficile and routine reports on other superbugs that lead to bloodstream
infections and pneumonias.
Also, under the new legislation, the Illinois
Department of Public Health will begin tracking MRSA infections acquired in
community settings such as gyms or housing complexes, a growing problem
throughout the area.
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