mrsa2MRSA and hospital infections are on the increase as are the related legal claims.  The scientific, public policy and legal liability questions were addressed during a Dec. 11, 2008 teleconference where four panelists offered background, perspective and discourse.    This is Part 3 of 4 posts made up of excerpts from the recording.   Barry Kreiswirth, Ph.D. is a molecular epidemiologist and director of the Public Health Research Institute’s Tuberculosis Center.   This is an excerpt from his comments.

“The first thing  . . .  Staph aureus lives on mucus membrane.  It lives in your nose and it colonizes vaginas in women.  It likes to be in moist environments.  On your skin is mostly Staph epidermidis, so it is another type of Staphylococci, but that is okay because there is still enough carriage out there that this problem is enormous.  There is no question about it.”

“So somewhere between 25 to 30 percent of all people carry Staph aureus in their nose at some point in time.  Interestingly though, there is about 50 percent of the population who never carry Staph aureus in their nose.  We don’t know why.  The point that is important I think for a lot of these studies that Betsy has talked about and in terms of negation is that carriage is transient, meaning that people pick up Staph aureus, carry it in their nose and then a week later they won’t have it.”

“. . .  from the litigation point of view this is going to be the problem going forward in terms of lawsuits.  I must say that I have actually been involved historically in a couple of these lawsuit cases.  There are a couple of problems in proving events in a hospital.  The biggest problem you have to prove that transmission is taking place is transmission can happen in a number of ways.”

barry-kreiswirth“Let’s talk about MRSA.  If I come in with MRSA in my nose, that bug can be basically the cause of my infection; through to some manipulation they put a catheter in my arm and then that bug infects the catheter and I get a bloodstream infection.  In that case it is a nosocomial event because it happened in the hospital but it was in this case caused by my own bug.  The other way it happens is simply a healthcare worker or someone else in the hospital is the source of the infection or some type of contaminated surface.”

“To prove that you have a nosocomial event is simply just based on the time of the event versus the time of admission.  You got it in the hospital but proving that it was actually transmission between or among patients or within the same patient requires two things.  It requires the laboratory to actually save that bacteria to be able to test it, and then it requires a lab like mine or an equivalent lab to actually prove that those two bacteria are the same.  Just because they are both MRSA doesn’t mean they are the same MRSA.”

The teleconference was produced by HB Litigation Conferences LLC, formerly Mealey’s Conferences.  For more information go to the Archives section of, or write to