Hawai'i hospitals, concerned about high rates of an antibiotic-resistant "superbug" called Methicillin-resistant Staphylococcus aureus, are turning to increased vigilance against the infection to reduce its incidence.

The Queen's Medical Center has made reducing the infection one of its goals this year, while Kaiser Permanente has formulated a strategy for preventing spread of the sometimes-deadly infection among patients.

Other hospitals are said to be focused on reducing infection rates, which are the highest in the country, according to one study.

"It's a problem for every hospital here in Hawai'i," said Frank Appel, director of quality and patient safety for Queen's. "I think we're all trying to get better at dealing with this."

Last month, the Centers for Disease Control and Prevention reported severe MRSA infections were twice as high as previously thought and now kill more people than AIDS. The CDC's findings were of interest to local hospitals because another study found Hawai'i has the highest prevalence rate in the nation: 91 cases for every 1,000 patient days. That's almost twice the national rate of 46.3.

Appel said patients with MRSA have a five times greater risk of death, require more complex care, patient and family education and are likely to have charges and hospital stays that are three times higher on average. At Queen's, there are 120 to 130 MRSA cases a year; the added cost from the infections is an estimated $4.2 million a year, or $35,000 per patient.

That same study by the Association for Professionals in Infection Control and Epidemiology found 74 percent of cases were traced to infections in healthcare settings, while 24 percent were community associated.

MRSA was one of the bigger topics of a discussion at last week's Hawaii Medical Service Association Hospital Summit, an annual meeting in which hospital personnel gather to discuss and trade information on programs that advance the quality of patient care.

The conference was run in conjunction with the Institute for Healthcare Improvement, which advocates nationally for lower medical errors. MRSA is among the topics being examined by the institute as it pursues a goal of reducing medical harm.

Experts say Hawai'i's higher rate may be due to the state's warm, moist climate that favors bacterial growth and outdoor lifestyle. Groups more prone to getting MRSA in the community include Pacific Islanders, the homeless and elderly people.

Healthcare officials say that soap and water, avoiding contact with other people's wounds and not sharing personal items such as towels, toothbrushes and razors are a way to lessen chances of the infection.

Queen's last year did a test project in which it focused on reducing MRSA at two intensive care units, seeing if simple solutions could reduce prevalence. This included making sure proper hand hygiene was conducted before and after patient contact or donning or removing gloves. The hospital also examined proper use of gloves and cleaning of equipment.

It then did an informational flier to staffers, making a "case for action" and posting signs at sinks, glove boxes, storage areas and on computer carts that are wheeled from room to room.

The result was that MRSA rates were reduced by about half during the two-week monitoring period.

"The good news is simple interventions were successful in reducing the MRSA rate," Appel said.

The bad news? "There's still a lot of room for improvement."

Kaiser reported at the HMSA Hospital summit that it had formulated strategies for preventing transmission of MRSA among patients.

This included putting patients with the infection in single rooms and using special precautions for contact with the patient, including gloves. Hand hygiene is stressed, along with decontamination of the environment and equipment and a number of other surveillance and precautionary actions.

Reach Greg Wiles at gwiles@honoluluadvertiser.com.