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Patients Develop Superbug MRSA Infections After Undergoing MRI Scanning Posted 18 November 2008 @ 09:05 am ET |
Numerous patients have developed "Superbug" infections that are resistantto conventional antibiotics after their MRI. Methicillin-resistantStaphylococcus aureus (MRSA) is one of the most common superbugs thatpatients have contracted after undergoing an MRI scan.
The most famous of these cases is that of 15-year-old honor roll studentNile Moss, who died from an MRSA infection after an outpatient visit to ahospital where he underwent an MRI. After leaving the hospital, Niledeveloped a high temperature. Three days after being admitted to thehospital, he died.
The Center for Disease Control and Prevention (CDC) reports that 1.7million people in the United States contract a hospital acquired infectioneach year, and more than 100,000 people die each year as a result of theseinfections. Reports show that, in 2005, nearly 19,000 people died fromhospital acquired infections. Hospital acquired infections are killing morepeople each year than AIDS.
After hearing of Nile's death, California State Senator Elaine Alquist wasprompted to sponsor California SB1058, "The MRSA reporting and screeningbill." Governor Arnold Schwarzenegger recently signed the bill into law,along with another bill designed to establish more rigorous infectioncontrol and training programs in hospitals.
An example that is occurring more frequently involved an elderly patientscheduled for cardiac bypass surgery. His doctors suspected that he mayhave had a small stroke and ordered an MRI. Two days after the MRI, thepatient became sick, was then diagnosed with MRSA and within days after theMRI, the patient died from the infection.
Peter Rothschild M.D., the author of the landmark paper "PreventingInfection in MRI: Best Practices for Infection Control in and Around MRISuites," says, "Infection control has such a low priority in MRI centers,that in the hundreds of MRI suites I have visited, I have rarely, if ever,seen a technologist clean the room and pads or even routinely wash theirhands between patients, much less have a written infection controlprocedure. Patients have no idea of the total lack of infection control inMRI centers, especially outpatient MRIs. However, the worst of all aremobile MRIs, which often have not been properly cleaned in years. Thesemobile MRIs pull up to the back of a doctor's office or a small communityhospital often after scanning highly contagious inmates at the localprison."
Dr. Rothschild warns, "Remove the sheet that covers the table pads and Ipromise you will be disgusted by what you see. Pads used on MRIs are tornand frayed and are often so contaminated that they smell. These pads shouldhave been replaced years ago, but continue to be used every day withoutcleaning between patients, and sometimes they are never cleaned at all. Iam not surprised that patients are becoming infected with MRSA followingMRI scans; the rooms and pads table are filthy."
A recent study, from Ireland, confirmed this type of contamination in MRIsuites by culturing the Superbug MRSA from the bore of an MRI. This raisedgreat concern from Dr. Rothschild, because this is an area that is rarely,if ever, cleaned, but frequently is in very close contact with patients.
"This is the first and only study to date ever to take cultures from an MRIfor the presence of Superbugs. I am extremely disappointed that noinvestigators in the United States have taken on the challenge to cultureMRIs and pads for Superbug," said Rothschild. "Therefore, one has to assumefrom the limited data and lack of infection control at these centers, thatthey are a source of deadly MRSA infections and every precaution must betaken for its prevention."
He continued, "Unfortunately, the solution that most imaging centers haveadopted is to ignore the problem and simply cover the torn and contaminatedtable pads with a clean sheet, thinking that this will somehow protect thepatient."
Dr. Rothschild's experience has been that essentially 100% of the tablepads use in MRIs over two to three years old are torn or frayed. This is indirect violation of clear guidelines by the CDC for environmental infectioncontrol in healthcare facilities. These guidelines state that damaged padsmust be discarded since they are impossible to adequately clean. Evenworse, some pads are so poorly made, and MRSA can penetrate frayed fabriccovers that appear intact. Rothschild says torn and frayed pads are itemsthat are often overlooked by MRI centers or not replaced in order to savemoney.
In response to these concerns, Dr. Rothschild recommends using a blacklight to identify biological contamination as well as a magnifying glass tosee torn and frayed areas on MRI pads. This procedure will allow MRIcenters to determine which pads must be replaced.
"There is nothing in my practice I am more concerned about than mypatients developing an infection by a Superbug like MRSA, especially afteran MRI," warns Richard Nolan M.D., an orthopedic surgeon. "If a patientbegins to develop an infection from their pre-op MRI, any subsequentsurgical results could be catastrophic. I have been ordering MRIs for yearsand have extensive experience with the lack of any semblance of infectioncontrol at these MRI centers. That is why I ask to see the center'sinfection control policy and make a visit to the center to see for myself,especially the condition of the pads. My motto is 'No infection controlpolicy, no patients.' Unfortunately, that is the only way I have found toget MRI centers to take this issue seriously."
"It is only a matter of time before attorneys begin to subpoena MRI centersto obtain the pads for inspection and culturing," said Rothschild. "Whatshould be of great concern for the MRI center is that from the MRSA found,a DNA 'fingerprint' can be acquired and then genetically matched to theMRSA cultured from an infected patient, leaving no doubt as to the sourceof the deadly infection."
"We live in a world that is increasingly under siege from extremelyaggressive and dangerous bacteria. As radiologists, we need to make everyeffort to ensure that the imaging centers are clean and safe for ourpatients. There is no excuse for not taking every precaution possible forprotecting our patients from these deadly Superbugs. Radiologists have,for too long, ignored the severe threat that these Superbugs present to allof our patients, especially immunosuppressed patients. This is dangerousand unacceptable."
Rothschild believes that, until MRI centers and the imaging community as awhole, take this threat seriously, more patients will contract MRSA aftertheir MRIs, and many of them may die from these infections.
In his recently released white paper, Rothschild calls for more infectiousdisease control policies in the industry and patient education on how toprevent contracting a Superbug infection from MRI scans.
To request a copy of Dr. Rothschild's white paper, titled "PreventingInfections in MRI: Best Practices for Infection Control in and around MRISuites," contact Doug Kohl, Sierra Communications, (209) 586-5887, ordkohl@mlode.com. More information on Superbug infections in MRI can befound at www.patientcomfortsystems.com
About Peter Rothschild, M.D.
Dr. Peter Rothschild is considered one of the world's foremost MRI experts.He formerly served as Medical Director of the research laboratory at theUniversity of California, San Francisco, where he helped develop the firstcommercially available Open MRI scanner. He is the editor of the firsttextbook on Open MRI, authored numerous papers on the subject and is asought after speaker who lectures on MRI and its future. Dr. Rothschild isa Board Certified Radiologist and served as an Adjunct Assistant Professorof Radiology at the University of California at San Francisco. He earnedhis M.D. degree in 1981 from the University of Louisville, in Louisville,Kentucky. He is founder and president of Patient Comfort Systems, Inc., acompany dedicated to patient comfort and safety.
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Contact:Doug KohlSierra Communications(209) 586-5887dkohl@mlode.com
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