Doctors at a North Carolina hospital report that about 160 patients were exposed to staph infection when surgical instruments weren’t properly sterilized.

Surgical instruments used on patients Oct. 5-7 were cleaned, disinfected, and packaged but hadn’t been sterilized with steam, said chief medical officer Dr. Eugene Wright.

Dr. Wright said the instruments were believed free of blood borne diseases like HIV and Hepatitis B and C.

Officials also said surgical patients routinely get antibiotics.

Dr. Chuck Chima, physician adviser to infection control at the hospital, said steam sterilization is the third step of the disinfection process and without it the instruments could be contaminated.

“Most of the cleaning process had gone through,” Chima said. “The steam sterilization is sort of an insurance.”

Symptoms of staph infection include redness, swelling, pain, and warmth at the surgical site as well as fever and drainage from the surgical area, swollen glands, and a red streak from the infection site.

Wright said the hospital discovered the problem Oct. 6 when a technician noticed that an instrument package hadn’t been steamed. Packages have chemical indicators that show whether they have been exposed to steam.

– by Gene J. Koprowski, Editorial Director

Infection protection measures needed.

Posted: October 16th, 2008 under Antibiotic Resistant, Diseases, Hand Hygiene.
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A Boy Scout reservation in Virginia has been closed after more than a dozen scouts there were sickened by the deadly       E. coli bacteria, an official said. E. coli is a bacterium that infects humans through tainted food, handling animals or swimming in contaminated water. The disease can cause severe food poisoning in people but not everyone exposed to it becomes ill, said Seth Levine, a Virginia state epidemiologist. But, individuals who do have the affliction usually undergo stomach cramps, watery bloody diarrhea, fever, and chills. The infection can also harm organs like kidneys.

According to the Centers for Disease Control and Prevention, E. coli infects an estimated 73,000 people and kills 61 a year in the U.S. 

According to officials of the National Capital Area Council of the Boy Scouts of America, the local camp was closed after discovering that more scouts presented with symptoms of the infection. Overall, 16 Boy Scouts and an adult leader are victims of the infection, with two of the boys being in serious condition.

The Virginia Department of Public Health investigated the site, but, according to the scouts,  “the source of the bacteria remains unconfirmed.”

As part of the ongoing infection control plan, the council announced it would get in touch with scouts scheduled for camp this week and the ones who were there last week. If the boys show any symptoms of the infection, the scouting organization recommends that they immediately seek medical care.

– by Gene J. Koprowski, Editorial Director

Posted: August 4th, 2008 under Anti-Bacterial Resources, Diseases, E. Coli, Hand Hygiene.
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The health department closed the Hawaiian Falls Adventure Park in Garland, Texas, this week because of potential cryptosporidiosis contamination.

A person who swam in the pool there has tested positive for crypto, an intestinal infection that causes diarrhea, cramping, nausea or vomiting, doctors said. The city closed all of the water attractions at Hawaiian Falls while park employees treat the water with chlorine to destroy any contaminants. Another Hawaiian Falls facility in nearby Mansfield, Texas, closed Wednesday night for the water to be treated as a precaution. The Hawaiian Falls in The Colony, Texas will close Thursdsay night for similar treatment. This is just the latest cryptosporidiosis scare in the Dallas-Fort Worth area. According to news reports, the following incicents have been reported recently: 

• Burger’s Lake in Fort Worth reopened last weekend after at least 20 people became sick. The lake was treated for crypto.
• All YMCA of Metropolitan Dallas pools will close Thursday night or Friday night while the water is treated for crypto.
• Play grounds at Mildred Dunn Park and Campbell Green Park in Dallas were closed last weekend, after children became ill. Those spraygrounds reopened after treatment. Now the city plans to treat all 28 pools and spraygrounds every week.
• Fifteen Tarrant County YMCA pools were closed Thursday, July 24, for crypto treatment. They reopened over the weekend.
• City pools in Arlington were treated Wednesday, July 23.
• Splash Station in Cleburne was treated for crypto Saturday, June 26, after an employee was infected with the parasite, according to doctors.

Good infection control practices are required to combat this disease. If you swim in a pool that may have been tainted with crypto, make sure you use disinfectants when getting out of the water.

– by Gene J. Koprowski, Editorial Director

Cryptosporidiosis threatens swimmers in Texas.

Posted: July 31st, 2008 under Diseases, Hand Hygiene.
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The first U.S. registry of complicated skin and soft tissue infections (cSSTIs), dubbed the Skin and Soft Tissue Infection Hospital Registry (SSTIR), this week began enrolling patients. The registry plans to enroll more than 1,200 hospitalized patients by the end of this year with the goal of gaining a better understanding of treatment patterns and improving patient outcomes, according to media reports.

Sponsored by Ortho-McNeil, division of Ortho-McNeil-Janssen Pharmaceuticals, Inc., more than 50 hospitals nationally have agreed to participate in this prospective, multi-center registry, which will comprehensively characterize the four major types of cSSTIs: diabetic foot infections, surgical site infections, deep soft tissue abscesses and cellulitis, an infection of tissue under the skin.

“Physicians are treating more and more patients with complicated skin infections in hospitals across the U.S., and the emergence of resistant pathogens has made the situation even more complex,” said Dr. Susan Nicholson, MD, therapeutic area leader for internal medicine at Ortho-McNeil. “This data will give physicians insight into how to manage these difficult-to-treat infections.”

Skin and soft tissue infections account for nearly 10 percent of all hospital admissions in the U.S. Researcher say the most common types of cSSTIs are post-operative surgical site infections, which represent 25 percent of all hospital infections.

According to the National Institutes of Health (NIH), 111,000 people with diabetes are hospitalized with foot infections every year, and as many as 3.09 million adults will develop a diabetic foot infection in their lifetime.

– by Gene J. Koprowski, Editorial Director

Skin infections increasingly common, NIH says.

Posted: July 25th, 2008 under Developing Diseases, Diseases, Hand Hygiene, MRSA.
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An elderly female patient at Cape Cod Hospital, not far from Boston, tested positive for a rare brain disorder called Creutzfeldt-Jakob disease, otherwise known as Mad Cow Disease.

The infectious, degenerative disorder leads to rapid death, health officials said.

Only three such cases of the particular strain have been identified in the U.S., and all of those were in patients who had come from the U.K.

According to Alfred Demaria, the department of public health’s top epidemiologist, the disease is not known to be communicable and that there is no need for alarm.

“It’s a very rare disease,” Demaria said. “There’s a lot of things that threaten people every day that are much, much, more common than this.”

– by Gene J. Koprowski, Editorial Director

Mad Cow disease infection devastating to the brain — for man and beast alike.

Posted: July 24th, 2008 under Diseases, Hand Hygiene, Mad Cow Disease.
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Another patient has been infected with the potentially deadly Legionnaires’ disease in upstate New York,  and public health officials there are saying that the bacteria which causes the deadly respiratory ailment has been found at a second site, a Syracuse nursing home.

Scientists searching for the source of the outbreak discovered the “Legionella bacteria that causes the illness in the water system of the 526-bed Van Duyn Home and Hospital,” said Gary Sauda, the Onondaga County director of environmental health.

The disease is a frightful form of pneumonia. Patients become infected by inhaling airborne water droplets that contain the bacteria. In epidemics of this disease, people up to two miles away from the source can be infected. The nursing home and hospital are located less than a half mile apart.

Thu far one person has died since the outbreak began June 30, and another 12 have been infected.

Investigators suspect the outbreak was caused by Legionella bacteria discovered in one of the air conditioning cooling towers at Community General Hospital of Syracuse, N.Y. but they have not yet definitively proven that hypothesis. Six of 13 people infected by the bacteria were Community General patients.

– by Gene J. Koprowski, MA, Editorial Director

Nursing home patients at risk of infection by Legionella bacteria.

Posted: July 17th, 2008 under Droplet Precautions, Hand Hygiene, Impaired Immunity, Legionnaires' Disease, Masks Control Transmission.
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An E. coli outbreak traced to recalled beef in Michigan and Ohio is now spreading throughout the U.S., according to the Centers for Disease Control.

Other states, including New York, Kentucky, and Indiana, all now have one lab-confirmed case of a bacterial infection. CDC said that 41 cases were reported initially.

The outbreak has been traced to beef sold in Kroger supermarkets. The disease is linked to poor infection control measures. The Kroger Co. recalled ground beef sold in Michigan and Ohio stores. According to the CDC, Nebraska Beef Ltd. supplied the meat, ultimately recalling 5.3 million pounds of beef.

One patient, located in Kentucky, lives near Ohio, and traveled across state lines with the infection, said Mark Sotir, a CDC investigator working on the case.

All of the illnesses in the outbreak are attributed to the same type of E. coli, one that causes a deadly bacterial infection.  CDC officials say 21 of the victims have been hospitalized and one developed kidney failure, but no one has died yet.

– Nancy Bruening, Managing Editor

E. coli outbreak linked to poor hand hygiene.

Posted: July 16th, 2008 under Diseases, Hand Hygiene.
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A group of senators is seeking to block importation of livestock from Argentina until the nation’s beef and pork supply is free of foot-and-mouth disease.

South Dakota Sen. Tim Johnson (D), and Wyoming Sen. Mike Enzi (R), introduced legislation to prevent livestock importation from Argentina until the U.S. Department of Agriculture certifies that it’s safe.

“Foot-and-mouth disease is a highly contagious and destructive disease, and we cannot risk the health of our livestock herds for questionable imports from Argentina,” said Johnson.

The region has suffered several outbreaks of the highly contagious disease that affects cloven-hoofed animals like cows and pigs lately. The viral illness can be spread through even minimal contact with infected animals, farm equipment or meat.

Johnson and Enzi said they introduced the bill after hearing from fretful farmers and ranchers about the safety of their livestock.

The Department of Agriculture proposed last year to expand beef imports from one region of Argentina. The United States has been free of the disease since 1929.

– by Gene J. Koprowski, MA, Editorial Director

Foot-and-mouth disease is contagious.

Posted: July 11th, 2008 under Developing Diseases, Diseases, Hand Hygiene, Pet Diseases.
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Half of all HIV-positive African adults who become infected with Salmonella bacteria die from what should be just a simple one-week affliction of diarrhea, according to scientists. “We have found the defect in the immune response that allows Salmonella to cross the mucosal barrier of the gut, enter the bloodstream and infect other organs,” said Andreas Bäumler, a UC Davis professor of medical microbiology and immunology and an author of the study.The results of the study, published online by Nature Medicine on March 23, disclose that viral infection of the intestine results in the depletion of a type of white blood cell, called Th-17, in the gut mucosa. This T helper lymphocyte produces IL-17, a cytokine or chemical messenger that plays a crucial role in the inflammatory response, recruiting other immune system cells to the infection site.This interruption in the gut’s immune response enables HIV to maintain enough potency to evade drug treatments, said Satya Dandekar, professor and chair of the department of medical microbiology and immunology.”It’s like putting out the fire, but leaving the embers smoldering,” Dandekar said.The rise in patients with acquired immune deficiency syndrome (AIDS) in sub-Saharan Africa has led to a dramatic increase in the frequency of non-typhoidal Salmonella serotypes (NTS), the strains of the bacteria that cause acute food-borne disease world wide.Dandekar had been researching the role of gut-associated lymphoid tissue in HIV.  “We think the real battle between an individual’s immune system and HIV is happening in the gut mucosa where there is massive destruction of immune cells,” Dandekar said.Other points of note, regarding the study:* Gut-associated lymphoid tissue accounts for 70 percent of the body’s immune system.* There is a gradual loss of CD4+ T cells, over time, systemically, in HIV patients.* But there is a very rapid loss of CD4+ T cells in the gut mucosa for HIV patients.”We are interested in looking at different molecules and compounds to see if we can boost mucosal immune defenses in the gut,” she said.The study was funded by the National Institutes of Health.– by Gene J. Koprowski, editorial director

HIV infection. Image source: Stanford University.

Posted: March 24th, 2008 under Feature Stories, HIV, Hand Hygiene.
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The mysterious, Iraqi War illness, acinetobacter infection, has become an “increasingly common problem” in hospitals and other health care facilities, according to a report in this week’s New England Journal of Medicine. The infection is being brought back to the U.S. by veterans of the Iraqi war, some suspect. Others suspect far worse than that cause as the source of the illness.  “Dramatic multihospital outbreaks have been described in Brooklyn, Chicago, northwestern Indiana, Detroit, and cities in Europe, South America, Africa, Asia, and the Middle East. Infections with Acinetobacter baumannii tend to occur in debilitated patients, mostly in ICUs,” the NEJM reported. 

Residents of long-term care facilities, particularly facilities caring for ventilator-dependent patients, with wounded veterans, are at increased risk, the medical journal reported.  Additional risk factors for colonization and infection are recent surgery, central vascular catheterization, tracheostomy, mechanical ventilation, enteral feedings, and treatment with third-generation cephalosporins, fluoroquinolones, or carbapenem antibiotics, the journal reported.

Common treatments recommended by physicians, according to NEJM:

* Antibiotic-susceptible acinetobacter strains have been treated with broad-spectrum cephalosporins,  (beta)-lactam-(beta)-lactamase inhibitor combinations — a combination that includes sulbactam, a drug marketed only in intravenous products in the U.S.

*  Carbapenems — including imipenem or meropenem, although there are reports of discordant susceptibility to carbapenems –  used alone or in combination with an aminoglycoside.

The lengthy of treatment is generally similar to that for infections caused by other gram-negative bacilli, is largely empirical, and depends mostly on the site of infection. In vitro studies have demonstrated either synergy or additive effects when polymyxins were used with imipenem, rifampin, or azithromycin against multidrug-resistant acinetobacter.

– by Gene J. Koprowski, editorial director

Acinetobacter infection may soon rival MRSA in hospitals.

Infection Protection has covered this emerging disease extensively, and will continue to monitor it. See,

Maryland hospital now mum on extent of bacterial infection from Iraq war
http://www.care-mates.com/blog/?p=106

Rare bacterial infection, known to attack military personnel, emerges in civilian patients
http://www.care-mates.com/blog/?p=72

Antibiotics accelerating evolution for lethal microbial population, report indicates
http://www.care-mates.com/blog/?p=124

Posted: March 20th, 2008 under Anti-Bacterial Resources, Antibiotic Resistant, Feature Stories, Hand Hygiene, MRSA.
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