Illinois Screenings for Staph are Now the Law

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.

By Judith Graham
Tribune staff reporter
August 21, 2007
Copyright © 2007, Chicago Tribune