St. Mary?s Hospital Leads State In Controlling Superbug Infection

St. Mary’s Hospital in Rogers is the first in Arkansas and one of the first in the nation to develop a program for fighting a new strain of bacteria that is immune to antibiotic treatment.

The program has been so effective that other hospitals are adopting and even buying it.

A new strain of bacterium enterococcus was detected in hospitals across the nation during the last few years. Because it is immune to vancomycin, which has been the medical profession’s greatest weapon in the fight against difficult infections, doctors have dubbed the new germ VRE (vancomycin-resistant enterococci). The bacteria can cause a variety of infections in patients, including the deadly septicemia.

“We are talking about something that can kill people,” says Charlene Ingwell, nurse educator at St. Mary’s Hospital. “This is scary stuff.”

Ingwell assembled a team of hospital staff members from every department and developed a policy for identifying patients with VRE and a procedure to keep the bacteria from spreading within the hospital. The result is a 100-page manual that has been copyrighted by the Sisters of Mercy Health System of St. Louis, which owns the hospital.

The policy and procedures have been adopted by five other hospitals in the Sisters of Mercy system. One copy of the manual was sold to a Memphis-area hospital for $350. Ingwell and Kathy Hicks, the infection control nurse for the hospital, have discussed the program with hospitals across the state and the nation.

As a result of the procedures, St. Mary’s Hospital has virtually eliminated the bacteria from the hospital. Before the program, as many as four patients a month were diagnosed with VRE.

The battle with VRE has been frustrating for hospitals. Traditionally, doctors have liberally prescribed antibiotics to fight many kinds of infection. Over time, the bacteria mutated and became resistant to many forms of antibiotics. Vancomycin was the answer to such bacteria until about six years ago when a strain was discovered that was immune to the drug.

Without the aid of vancomycin, health professionals began looking for other ways to combat the bacteria. Because VRE can live in colonies for as long as 30 days, it can survive on light switches, blood-pressure cuffs, stethoscopes, ink pens and curtains, and it can be carried from one hospital room to another.

At St. Mary’s, Ingwell and Hicks developed a program that combats the problem in two ways: controlling the transmission of the bacteria to other patients through an elaborate system of disinfection measures, and limiting the development of the bacteria by limiting the use of vancomycin.

The procedure requires doctors, nurses and family members to wear surgical gowns, masks and latex gloves when they are in the room with the patient. They remove the clothing before leaving the room and dispose of the items. When the patient leaves the room, janitors spend as much as three hours disinfecting it, which includes removing the curtains in the room.

Ingwell says she worked with the national Center for Disease Control in Atlanta to develop the procedures. The policy also has been approved by the Joint Commission for the Accreditation of Hospitals.