More Monk, less House
The Times’ series on MRSA pointed out our hospital-based MRSA challenges but did not mention that most people with MRSA infections are managed as outpatients at home. A better MRSA incidence would be found from our community microbiology laboratories. The stories also implied that individuals could be definitively tested to see if they carried or were cleared of MRSA.
When a person’s nasal culture is negative, can they still become infected from their own skin flora or give MRSA to someone else?
When a person’s nasal culture is positive, can they eradicate the organisms by taking antibiotics or will they always be colonized? Can antibiotics prevent surgical infection in a MRSA-colonized patient?
If Harborview should isolate MRSA patients, should a person at home with a MRSA-positive “spider bite” sleep in the same bed, use the same towels or even be in the same house as their spouse and school-aged children?
Cleanliness and hand washing are proven strategies back to Lister, Semmelweis and Pasteur — nasal cultures less so. We need to be less cavalier and more compulsive about cleanliness at the systems — both institutional and at personal levels.
We need less Dr. House and more Mr. Monk.
— James Mhyre, Bellevue