Sentinel-Echo.com

October 11, 2012

The war on staph: Mosley doing all he can to stamp out disease at LCDC

By Magen McCrarey
Staff Writer

LAUREL COUNTY, Ky. — A superbug has made its way through locked doors of Laurel County’s high security Detention Center, and Jailer Jamie Mosley said he is doing all he can to stamp it out.  

Staph infections cause 19,000 deaths annually and is the most communicable disease found in county jails across the U.S. Staph RS is a normal bacteria found on the skin’s surface, but methicillin resistant staphylococcus aureus (MRSA) has emerged as a superbug that appears on the skin as a red swollen boil and is highly contagious.

“When we do get someone that brings it (MRSA) in, we isolate them in order to make sure that they’re not spreading it to the other inmates,” Mosley said.

This precaution was not taken at the jail before he was elected more than a year and a half ago, and during that time MRSA was an epidemic. Since Mosley’s election, he’s taken the disease seriously as well as the hygiene of inmates, and reported cases have significantly declined.

“I used to be a transport officer and the amount of doctor visits I used to take out of here due to staph and boils have greatly reduced. We have such low numbers now its insignificant, I used to haul about four to five a day to get drained and treated,” said Lieutenant Rodney Gay at the jail.

The first step Mosley took after he took office was to hire a new medical staff of four nurses, whereas there was only one before. Those nurses are under the direction of a doctor, which visit the facility a couple of times a week. Other precautionary measures taken to bar the disease have been an increased regimen of cleaning the cells twice a day, the elimination of excess trash, the placement of hand sanitizers beside each cell entrance, and the purchase of anti-bacterial shower gel for cell community use.

“Inmates are more inclined to maintain better hygiene by having good clean showers and an aesthetically appealing facility--there’s some of those showers even I wouldn’t want to take a shower in,” Mosley said.

In this year, there have only been up to six confirmed cases of MRSA.

“We’ve handled it a little differently now, if we have an inmate who has a red area that becomes swollen, rather than culture that and wait to see if it’s going to develop into MRSA, we go ahead and put them on antibiotics just for the redness and swelling. So after that if you culture it, it’s really not accurate, because you’ve got antibiotics in there,” Mosley said, adding, “we try to get a step ahead of it before it gets to that point.”

Although the cases of MRSA have been said to have recently declined, Regional Epidemiologist Dr. Marion Pennington disagrees with Mosley’s antibiotic method, stating there is an over-use of antibiotics. The exact number of people entering the jail with MRSA is unknown, she used to be notified of all cases and forms of the disease until the new medical staff was hired. MRSA has most commonly entered through the jail upon inmates who have shared needles, and who have had skin-to-germ contact with others.  The bacteria is highly difficult to get rid of because MRSA can mutate to become resistant to antibiotics and can then only be rid of through other rare and expensive antibiotics. Pennington stated that the bacteria can live on a surface for up to several hours ready to pounce on its next victim. The jail has only recently begun charting the number of confirmed cases of MRSA, Mosley said to determine exactly how many of the cases derived from inmates entering the facility. The use of antibiotics is cost-effective in the long run Mosley said, because if an inmate’s irritated skin ends up not becoming MRSA, then he figured, “what’s the harm?”

“They’re not saving any money in the long-run by doing that, if anything they are compounding the problem by number one not finding out what it is and how to treat it and treat it properly,” Pennington said. There are two antibiotics currently used to treat MRSA, and doctors are beginning to see a bacteria resistance. At least eight to 10 discs with the bacteria inside are used when cultured to see which one is susceptible to an antibiotic.

“If you don’t know what that bacteria is, you just can’t jerk something off the shelf. There is not a do-all see-all placebo out there that takes care of everything--that’s why you need to culture. It could be something entirely different from MRSA too,” Pennington said. “The more antibiotics that you put out there, the more resistant bacteria are going to become to that antibiotic. Later on down the line your body may need to use the antibiotic and your body will be resistant to it. You may be developing a superbug in that jail.”

There are currently 370 inmates at the jail while the facility is continuing to undergo physical changes. The changes include new scrubs to wear, foam beds that include pillows to cut down on places for a bacteria to settle into, as well as new showers. The cleanliness of the facility is continually improving and will hopefully encourage inmates to carry on with the better hygiene practices after their release in the future, Mosley said.



mmccrarey@sentinel-echo.com