High levels of antibiotic resistance and low levels of ‘antibiotic literacy’ in the general public are on a dangerous collision course

MRSAPhoto credit: CDC, Janice Haney Car.

Guest Blogger Dr. Rodney E. Rohde (bio below) writes: The U.S. Department of Health and Human Services (HHS) has identified the reduction of healthcare-associated infections (HAIs) as an Agency Priority Goal for the Department. HHS is committed to reducing the national rate of HAIs by demonstrating significant, quantitative, and measurable reductions in hospital-acquired central line-associated bloodstream infections and catheter-associated urinary tract infections (1). In this national context, recent data show that Americans visit the doctor approximately 12 million times each year to get checked for suspected staphylococci or MRSA skin infections. Estimates are that 1 of every 20 hospital inpatients will contract a HAI (2).  This is roughly 270 deaths per day by one estimate – think of an airplane disaster with no survivors every day as a comparison. It appears that more people in the US now die from MRSA, especially healthcare acquired, than from HIV/AIDS.

MRSA incidence and the low levels of literacy about antibiotic resistant infections in the general public are on a natural collision course. The health implications for society are startling and this brewing public health storm should be a wake-up call for all involved in the prevention and treatment of MRSA and other antibiotic resistant infections. Traditional medical approaches to infection control, antibiotic prescribing and usage, and how the healthcare practitioner relates to the public in general, and to individuals in particular, are no longer adequate in light of this growing healthcare emergency. It has been my experience that individuals who are diagnosed with MRSA infections (and other HAIs) need an informed healthcare professional to explain a number of complicated issues to them to help the individual understand the dangers of these nasty antibiotic resistant infections. This, in turn, will lead to greater acceptance and adoption of infection control and prevention.

For example, I conducted a study for my dissertation that details the experiences of ten participants who have been diagnosed with MRSA (3). Briefly, this study provides a new model of how a person with MRSA in the general public learns and adapts to the infection. Their experiences emerged to create critical implications for practice and research. Almost all individuals had important advice for professionals about the nature of a consistent message for an MRSA plan. The embedded features of this plan were that people make the difference in these life-changing diagnoses. Likewise, all participants echoed the need for consistency of MRSA information and a step-by-step plan to manage the condition. Particular attention should be paid to the following areas: (a) the patient-healthcare provider interaction, specifically to create an open and non-threatening environment for learning to occur, (b) the delivery of critical information about the importance of having an MRSA diagnosis based on laboratory culture and antibiotic susceptibility testing, (c) specific education on what a MRSA infection looks like, including images/pictures and MRSA stories for patients, (d) the use of podcasts, digital video, and other electronic media (e.g. Facebook) to provide patient education beyond the initial MRSA diagnosis, (e) specific education about infection care, control, and prevention to themselves and others, and (f) guidance for individuals about sources of information and the credibility of sources. In regard to the use of podcasts and other electronic media, the message should be formed with a combination of stories from MRSA survivors and healthcare professionals to build a strong, synergistic media tool.

The implications for practice and research based on the literature and results of this study indicate a need to address issues of how the general public discovers, learns, and adapts to antibiotic resistant infections, especially MRSA. Likewise, this study emphasizes the critical importance of informing healthcare professionals and health educators (e.g. universities, schools, and other related institutions) about the need for better programs of patient education and continuing education surrounding the pre and post diagnosis of MRSA infections.  The participants in this study all emphasized the critical nature of talking to others that had already experienced MRSA with respect to getting an insider’s perspective on lessons learned. Finally, the participants in this study appeared to utilize self-directed learning and, to a lesser extent, transformational learning to challenge the healthcare system in regards to what content they needed about MRSA and how they might best learn to understand the disease. It may be possible to build on this desire to impact the healthcare system by inviting individuals who have experiences with MRSA to join a healthcare associated advisory committee.


  1. US Department of Health and Human Services, Health Care-Associated Infections.
  2. Department of Health and Human Services. HHS Action Plan to Prevent HealthCare-Associated Infections: Roadmap to Elimination.US Department of Health and Human Services, Washington, DC, USA (2012).
  3. Rohde, R.E. & Ross-Gordon, Jovita. MRSA model of learning and adaptation: a qualitative study among the general public. BMC Health Services Research, 2012, 12:88.

Guest Blogger Bio


Dr. Rodney E. Rohde is a Professor, Research Dean and Program Chair of the Clinical Laboratory Science program in the College of Health Professions, at Texas State University.

Dr. Rohde’s background is in public health and clinical microbiology. He has a bachelor’s degree in microbiology, a master’s degree in biology/virology and a PhD in education from Texas State. His dissertation was aligned with his clinical background: MRSA knowledge, learning and adaptation.

His research focuses on adult education and public health microbiology with respect to rabies virology, oral rabies wildlife vaccination, antibiotic resistant bacteria, and molecular diagnostics/biotechnology. He has published over 30 research articles and abstracts and presented at over 100 international, national and state conferences. He was awarded the 2012 Distinguished Author Award and the 2007 ASCLS Scientific Research Award for his work with MRSA. Recently, his work was the focus of an educational campaign regarding the important research focus of MRSA, which featured Dr. Rohde in a video by Texas State University that has been used by numerous media outlets. Learn more about his work here.